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Individual

DR. MARC ALLAN WALLACH

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
77 WESTPORT PLZ, SUITE 251, SAINT LOUIS, MO 63146-3107
(314) 434-7300
(314) 275-7680
Mailing address
77 WESTPORT PLZ, SUITE 251, SAINT LOUIS, MO 63146-3107
(314) 434-7300
(314) 275-7680

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
13366
MO

Other

Enumeration date
09/27/2005
Last updated
07/08/2007
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