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1976 Zumbehl Rd Saint Charles MO 63303-2721 | |
| (636) 395-4777 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1976 Zumbehl Rd, Saint Charles, Missouri |
| Authorized Official Name and Position | Celia Hayes (CREDENTIALING COORDINATOR) |
| Authorized Official Contact | 2175402100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1976 Zumbehl Rd Saint Charles MO 63303-2721 Ph: (636) 395-4777 | 1976 Zumbehl Rd Saint Charles MO 63303-2721 Ph: (636) 395-4777 |
| NPI Number | 1396117875 |
|---|---|
| Provider Enumeration Date | 10/23/2015 |
| Last Update Date | 03/10/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396117875 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Secondary |
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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