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14897 Clayton Rd Chesterfield MO 63017 | |
| (636) 227-1161 | |
| (636) 227-1161 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 14897 Clayton Rd, Chesterfield, Missouri |
| Authorized Official Name and Position | Sanford I Wax (PRESIDENT DENTIST OWNER) |
| Authorized Official Contact | 6362271161 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
14897 Clayton Rd Chesterfield MO 63017 Ph: (636) 227-1161 | 14897 Clayton Rd Chesterfield MO 63017 Ph: (636) 227-1161 |
| NPI Number | 1184798951 |
|---|---|
| Provider Enumeration Date | 11/20/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184798951 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 11565 (Missouri) | Primary |
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