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1319 Caulks Hill Rd Saint Charles MO 63304-6863 | |
| (636) 441-3430 | |
| (636) 441-5987 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1319 Caulks Hill Rd, Saint Charles, Missouri |
| Authorized Official Name and Position | Robert Weldon Thompson (TRES/SEC) |
| Authorized Official Contact | 6364413430 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1319 Caulks Hill Rd Saint Charles MO 63304-6863 Ph: (636) 441-3430 | 1319 Caulks Hill Rd Saint Charles MO 63304-6863 Ph: (636) 441-3430 |
| NPI Number | 1700188703 |
|---|---|
| Provider Enumeration Date | 11/23/2010 |
| Last Update Date | 11/23/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700188703 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 013916 (Missouri) | Secondary |
| 1223G0001X | Dentist - General Practice | 013954 (Missouri) | Primary |
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