| Gateway Oral And Maxillofacial Surgeons Of St Louis, P.c. | |
|
165 N. Meramec Ave Suite 300 Clayton MO 63105-3772 | |
| (314) 726-2755 | |
| (314) 726-9538 |
| Full Name | Gateway Oral And Maxillofacial Surgeons Of St Louis, P.c. |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 165 N. Meramec Ave, Clayton, Missouri |
| Authorized Official Name and Position | Daun M. Brandt (BUSINESS MANAGER) |
| Authorized Official Contact | 3147262755 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gateway Oral And Maxillofacial Surgeons Of St Louis, P.c. 165 N. Meramec Ave Suite 300 Clayton MO 63105-3772 Ph: (314) 726-2755 | Gateway Oral And Maxillofacial Surgeons Of St Louis, P.c. 165 N. Meramec Ave Suite 300 Clayton MO 63105-3772 Ph: (314) 726-2755 |
| NPI Number | 1184892028 |
|---|---|
| Provider Enumeration Date | 02/13/2008 |
| Last Update Date | 04/11/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184892028 | NPI | - | NPPES |
| 990001492 | Other | MO | MEDICARE GROUP ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 12435 (Missouri) | Primary |
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