| 100 West Dental | |
|
13759 Manchester Rd Ballwin MO 63011-6301 | |
| (618) 514-2520 | |
| Not Available |
| Full Name | 100 West Dental |
|---|---|
| Speciality | Dentist |
| Location | 13759 Manchester Rd, Ballwin, Missouri |
| Authorized Official Name and Position | Brandon Prior (OWNER/DENTIST) |
| Authorized Official Contact | 6185142520 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| 100 West Dental 1012 Arlington Dr Columbia IL 62236-1513 Ph: (618) 514-2520 | 100 West Dental 13759 Manchester Rd Ballwin MO 63011-6301 Ph: (618) 514-2520 |
| NPI Number | 1487219580 |
|---|---|
| Provider Enumeration Date | 05/03/2019 |
| Last Update Date | 05/03/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487219580 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | () | Primary |
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