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132 Chesterfield Towne Ctr Chesterfield MO 63005-1230 | |
| (636) 733-2363 | |
| (636) 536-6574 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 132 Chesterfield Towne Ctr, Chesterfield, Missouri |
| Authorized Official Name and Position | Kendra Walker (CREDENTIALING TEAM LEAD) |
| Authorized Official Contact | 2175408513 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
132 Chesterfield Towne Ctr Chesterfield MO 63005-1230 Ph: (636) 733-2363 | 132 Chesterfield Towne Ctr Chesterfield MO 63005-1230 Ph: (636) 733-2363 |
| NPI Number | 1740400894 |
|---|---|
| Provider Enumeration Date | 04/30/2007 |
| Last Update Date | 04/25/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740400894 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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