| Des Peres Dental Group Inc | |
|
13603 Barrett Office Drive Ste 104 St Louis MO 63021-7828 | |
| (314) 822-3868 | |
| (314) 822-1101 |
| Full Name | Des Peres Dental Group Inc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 13603 Barrett Office Drive, St Louis, Missouri |
| Authorized Official Name and Position | Donald Glenn Richardson (VP) |
| Authorized Official Contact | 3148223868 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Des Peres Dental Group Inc 13603 Barrett Office Drive Ste 104 St Louis MO 63021-7828 Ph: (314) 822-3868 | Des Peres Dental Group Inc 13603 Barrett Office Drive Ste 104 St Louis MO 63021-7828 Ph: (314) 822-3868 |
| NPI Number | 1912056151 |
|---|---|
| Provider Enumeration Date | 01/09/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912056151 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 12234 (Missouri) | Primary |
| 1223G0001X | Dentist - General Practice | 12222 (Missouri) | Secondary |
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