Ladue Dental Group | |
8859 Ladue Road Ladue MO 63124 | |
(314) 983-8011 | |
(314) 983-8112 |
Full Name | Ladue Dental Group |
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Speciality | Dentist - General Practice |
Location | 8859 Ladue Road, Ladue, Missouri |
Authorized Official Name and Position | Bryan K Watanabe (OWNER) |
Authorized Official Contact | 3149838011 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Ladue Dental Group 17000 Red Hill Ave Irvine CA 92614-5626 Ph: (714) 945-8890 | Ladue Dental Group 8859 Ladue Road Ladue MO 63124 Ph: (314) 983-8011 |
NPI Number | 1851784490 |
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Provider Enumeration Date | 03/06/2015 |
Last Update Date | 03/06/2015 |
Identifier | Type | State | Issuer |
---|---|---|---|
1851784490 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |