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C M WALLACE DDS PA
NPI 1578612925
Dentist - General Practice in Bonita Springs, FL

Active since January 08, 2007
8951 BONITA BEACH RD, BONITA SPRINGS, FL 34135(239) 992-8555(239) 992-8644 Get Directions Write a Review

NPPES record last updated: September 29, 2010. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About C M Wallace Dds Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

C M WALLACE DDS PA (NPI 1578612925) is a healthcare organization registered as a general practice in Bonita Springs, Florida and active in the NPI registry since January 2007. The organization lists Charles Macon Wallace, Owner President, as its authorized official.

NPPES Registry Identity

NPI1578612925
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameC M WALLACE DDS PA
Location Address8951 BONITA BEACH RDBonita Springs, FL 34135-4201
Mailing Address8951 Bonita Beach RdBonita Springs, FL 34135-4201 · (239) 992-8555 · Fax (239) 992-8644
Phone(239) 992-8555
Fax(239) 992-8644
Organization SubpartNo
Authorized OfficialCharles Macon WallaceOwner President · (239) 643-4746
Enumeration DateJanuary 8, 2007
Last NPPES UpdateSeptember 29, 2010
✔ NPI 1578612925 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in FL · DN14024
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
8951 BONITA BEACH RD, Bonita Springs, FL 34135
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is C M Wallace Dds PA's NPI number?

The NPI number for C M Wallace Dds PA is 1578612925. It was assigned to this organization in the NPPES registry on January 8, 2007.

Where is C M Wallace Dds PA located?

C M Wallace Dds PA is located at 8951 Bonita Beach Rd, Bonita Springs, FL 34135. The listed phone number is (239) 992-8555.

What is C M Wallace Dds PA's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

When was this NPI record last updated?

The NPPES record for C M Wallace Dds PA was last updated on September 29, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.