| Hawthorn Dental - St. Charles | |
|
2300 S Old Highway 94 Saint Charles MO 63303-5622 | |
| (636) 928-8400 | |
| (636) 928-0480 |
| Full Name | Hawthorn Dental - St. Charles |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2300 S Old Highway 94, Saint Charles, Missouri |
| Authorized Official Name and Position | Bruce Stolle (CO-OWNER DENTIST) |
| Authorized Official Contact | 6369288400 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Hawthorn Dental - St. Charles 2300 S Old Highway 94 Saint Charles MO 63303-5622 Ph: (636) 928-8400 | Hawthorn Dental - St. Charles 2300 S Old Highway 94 Saint Charles MO 63303-5622 Ph: (636) 928-8400 |
| NPI Number | 1003948027 |
|---|---|
| Provider Enumeration Date | 03/12/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003948027 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (Missouri) | Primary |
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