| Crestwood Dental Group | |
|
10000 Watson Road Suite J St Louis MO 63126-1854 | |
| (314) 821-2134 | |
| (314) 821-0381 |
| Full Name | Crestwood Dental Group |
|---|---|
| Speciality | Dentist |
| Location | 10000 Watson Road, St Louis, Missouri |
| Authorized Official Name and Position | James William Maxwell (PRESIDENT) |
| Authorized Official Contact | 3148212134 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Crestwood Dental Group 10000 Watson Road Suite J St Louis MO 63126-1854 Ph: (314) 821-2134 | Crestwood Dental Group 10000 Watson Road Suite J St Louis MO 63126-1854 Ph: (314) 821-2134 |
| NPI Number | 1184721268 |
|---|---|
| Provider Enumeration Date | 09/20/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184721268 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 2002029903 (Missouri) | Primary |
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