| Hawk Ridge Dental Care | |
|
8631 Highway N Lake St. Louis MO 63367 | |
| (636) 561-4540 | |
| (636) 561-4601 |
| Full Name | Hawk Ridge Dental Care |
|---|---|
| Speciality | Dentist |
| Location | 8631 Highway N, Lake St. Louis, Missouri |
| Authorized Official Name and Position | Angela K Pernoud (SECRETARY) |
| Authorized Official Contact | 6365614540 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Hawk Ridge Dental Care 8631 Highway N Lake St. Louis MO 63367 Ph: (636) 561-4540 | Hawk Ridge Dental Care 8631 Highway N Lake St. Louis MO 63367 Ph: (636) 561-4540 |
| NPI Number | 1013190875 |
|---|---|
| Provider Enumeration Date | 12/14/2007 |
| Last Update Date | 12/14/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013190875 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 2006021264 (Missouri) | Primary |
Bankhead Dds Orthodontics Dds Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 8631 State Highway N, Lake St. Louis, MO 63367 Phone: 636-226-1050 Fax: 636-898-2001 |