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MCKENZIE WALLACE, STUDENT

STUDENT

General Practice Dentistry

NPI: 1194429597Individual

Specialties, Licenses & Credentials

Student in an Organized Health Care Education/Training Program

Code: 390200000X

Dentist — General Practice

Code: 1223G0001X

D14879(MN)

Contact & Hours

Address
1026 7TH ST W
SAINT PAUL, MN 55102

Quick Facts

NPI
1194429597
Entity Type
Individual
Gender
Male
Medicare
Not confirmed
Specialties
2
Locations
1

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