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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MCKENZIE WALLACE, STUDENT

Active

MCKENZIE WALLACE, STUDENT is a General Dentistry healthcare provider located in SAINT PAUL, Minnesota. NPI 1194429597 is currently active in the NPPES registry. Verify at CMS.

General Dentistry · SAINT PAUL, MN

Registration Details

NPI Number
1194429597
Provider Type
Individual
Gender
Male
NPI Issued
Mar 29, 2023 (3.3377574105134 yrs)
Last Updated
May 25, 2023
License
D14879 (MN)

Practice Information

Address
1026 7TH ST W
SAINT PAUL, MN, 551023828
Browse MN providers · Browse ZIP 55102
Phone
6517589500
Primary Specialty
General Dentistry
1223G0001X
Additional Specialty
General Dentistry

Other General Dentistry Providers in SAINT PAUL, MN

Name Credential NPI
DR. GREGORY MICHAEL SHEEHAN DDS 1376549352
DR. DAVID RISCHALL D.D.S. 1891783379
DR. JEFFREY J ROZINKA DDS 1942299896
DR. MARK W. HOUSTON DDS 1770572414
DR. TARA VONNE BRODERSEN DDS 1336138882
DR. PHUONG-GIANG THI PHAM DDS 1427047638
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.