| Stephen W. Hiatt Dds And Maryann L. Udy Dmd Pc | |
|
2992 Highway K Ste 133 O Fallon MO 63368-7861 | |
| (636) 978-6967 | |
| (636) 978-5905 |
| Full Name | Stephen W. Hiatt Dds And Maryann L. Udy Dmd Pc |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 2992 Highway K, O Fallon, Missouri |
| Authorized Official Name and Position | Lana S. Wisniewski (BUSINESS MANAGER) |
| Authorized Official Contact | 6369786967 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Stephen W. Hiatt Dds And Maryann L. Udy Dmd Pc 5551 Winghaven Blvd. Ste. 210 O'fallon MO 63368 Ph: (636) 978-6967 | Stephen W. Hiatt Dds And Maryann L. Udy Dmd Pc 2992 Highway K Ste 133 O Fallon MO 63368-7861 Ph: (636) 978-6967 |
| NPI Number | 1336314079 |
|---|---|
| Provider Enumeration Date | 04/24/2008 |
| Last Update Date | 06/28/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336314079 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 011813 (Missouri) | Primary |
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