| Boulevard Dental Care L.l.c. | |
|
2645 Muegge Rd Saint Charles MO 63303-3145 | |
| (636) 939-6868 | |
| (636) 447-3611 |
| Full Name | Boulevard Dental Care L.l.c. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2645 Muegge Rd, Saint Charles, Missouri |
| Authorized Official Name and Position | Randall Craig Reyes (MANAGER) |
| Authorized Official Contact | 6369396868 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Boulevard Dental Care L.l.c. 11939 Manchester Rd #120 Des Peres MO 63131-4502 Ph: (636) 939-6868 | Boulevard Dental Care L.l.c. 2645 Muegge Rd Saint Charles MO 63303-3145 Ph: (636) 939-6868 |
| NPI Number | 1831247048 |
|---|---|
| Provider Enumeration Date | 01/07/2007 |
| Last Update Date | 07/30/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831247048 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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