| Dr. Maryana Kirolos | |
|
310 E Elm St O Fallon MO 63366-2606 | |
| (636) 240-6858 | |
| (636) 272-4278 |
| Full Name | Dr. Maryana Kirolos |
|---|---|
| Speciality | Dentist |
| Location | 310 E Elm St, O Fallon, Missouri |
| Authorized Official Name and Position | Maryana Kirolos (OWNER/DENTIST) |
| Authorized Official Contact | 6362406858 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. Maryana Kirolos 310 E Elm St O Fallon MO 63366-2606 Ph: (636) 240-6858 | Dr. Maryana Kirolos 310 E Elm St O Fallon MO 63366-2606 Ph: (636) 240-6858 |
| NPI Number | 1053862961 |
|---|---|
| Provider Enumeration Date | 10/17/2016 |
| Last Update Date | 10/17/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053862961 | NPI | - | NPPES |
| 1114205929 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 20125019136 (Missouri) | Primary |
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