| La Cross Dental | |
|
11634 W Florissant Ave Florissant MO 63033-6723 | |
| (314) 322-4719 | |
| (314) 837-9778 |
| Full Name | La Cross Dental |
|---|---|
| Speciality | Dentist |
| Location | 11634 W Florissant Ave, Florissant, Missouri |
| Authorized Official Name and Position | David Guilbeault (OWNER) |
| Authorized Official Contact | 6186921110 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| La Cross Dental 11634 W Florissant Ave Florissant MO 63033-6723 Ph: (314) 322-4719 | La Cross Dental 11634 W Florissant Ave Florissant MO 63033-6723 Ph: (314) 322-4719 |
| NPI Number | 1952702821 |
|---|---|
| Provider Enumeration Date | 09/10/2014 |
| Last Update Date | 09/10/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952702821 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 2013030663 (Missouri) | Primary |
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