| Brevco Family Dentistry | |
|
100 Brevco Plaza Suite 104 Lake Saint Louis MO 63367 | |
| (636) 561-9000 | |
| (636) 561-9001 |
| Full Name | Brevco Family Dentistry |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 100 Brevco Plaza, Lake Saint Louis, Missouri |
| Authorized Official Name and Position | Kendra Walker (CREDENTIALING TEAM LEAD) |
| Authorized Official Contact | 2175408513 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Brevco Family Dentistry 100 Brevco Plaza Suite 104 Lake Saint Louis MO 63367 Ph: (636) 561-9000 | Brevco Family Dentistry 100 Brevco Plaza Suite 104 Lake Saint Louis MO 63367 Ph: (636) 561-9000 |
| NPI Number | 1972791986 |
|---|---|
| Provider Enumeration Date | 10/04/2007 |
| Last Update Date | 04/26/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972791986 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 13950 (Missouri) | Primary |
Borello Orthodontics Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 6288 Ronald Reagan Dr., Lake Saint Louis, MO 63367 Phone: 636-625-4224 | |
Missouri Dental Professionals, Richard Straus, D.m.d., P.c. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 6492 Ronald Reagan Dr, Lake Saint Louis, MO 63367 Phone: 636-626-2071 Fax: 636-626-2073 |