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2386 N Highway 67 Suite 2 Florissant MO 63033-2034 | |
| (314) 355-4140 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2386 N Highway 67, Florissant, Missouri |
| Authorized Official Name and Position | Amy Gibbons (OPERATIONS MANAGER) |
| Authorized Official Contact | 6182482038 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
24 Ginger Creek Pkwy Glen Carbon IL 62034-3502 Ph: (618) 248-3463 | 2386 N Highway 67 Suite 2 Florissant MO 63033-2034 Ph: (314) 355-4140 |
| NPI Number | 1366888331 |
|---|---|
| Provider Enumeration Date | 05/17/2013 |
| Last Update Date | 02/24/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366888331 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 2000174030 (Missouri) | Primary |
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