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100 Thf Blvd. Chesterfield MO 63005 | |
| (225) 291-5272 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 100 Thf Blvd., Chesterfield, Missouri |
| Authorized Official Name and Position | Andre Bruni (OWNER) |
| Authorized Official Contact | 2257672273 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
4451 Bluebonnet Blvd F Baton Rouge LA 70809 Ph: (225) 291-5272 | 100 Thf Blvd. Chesterfield MO 63005 Ph: (225) 291-5272 |
| NPI Number | 1144591041 |
|---|---|
| Provider Enumeration Date | 01/24/2012 |
| Last Update Date | 01/24/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144591041 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 2011040263 (Missouri) | Primary |
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