Marc Allan Wallach DDS

NPI 1104813831 - Dentist - 122300000X

NPI Details
NPI 1104813831
Gender Male
Enumeration Date 09/27/2005
Last Updated 07/08/2007
Entity Type Individual
Active Over 11 years ago
Practice Location
77 WESTPORT PLZ
SUITE 251
SAINT LOUIS MO, 63146-3107, US
Phone (314) 434-7300
Fax (314) 275-7680
Business Location
77 WESTPORT PLZ
SUITE 251
SAINT LOUIS MO, 63146-3107, US
Phone (314) 434-7300
Fax (314) 275-7680
Toxanomy
Taxonomy Code 122300000X
License State Missouri
License Number 13366
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According to our database, Dr. Marc Allan Wallach DDS NPI is 1104813831, taxonomy code is 122300000X and license number is 13366, license state is located at Missouri. Marc Allan Wallach DDS physically located at 77 Westport Plz, Saint Louis MO, 63146-3107. NPI Number Marc Allan Wallach DDS has the Individual type.

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1104813831 NPI number is provided on an as is basis without warranty of any kind. 1104813831 is maintained by the National Plan & Provider Enumeration System. The contents of Marc Allan Wallach DDS are for informational purposes only.