| Monticello Sleep Dentistry LLC | |
|
530 Huber Park Ct Ste 201 Weldon Spring MO 63304-8621 | |
| (636) 244-2080 | |
| Not Available |
| Full Name | Monticello Sleep Dentistry LLC |
|---|---|
| Speciality | Clinic/Center |
| Location | 530 Huber Park Ct Ste 201, Weldon Spring, Missouri |
| Authorized Official Name and Position | Numpol Dejtiranukul (SOLE MBR/DENTIST) |
| Authorized Official Contact | 6362997737 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Monticello Sleep Dentistry LLC 530 Huber Park Ct Ste 201 Weldon Spring MO 63304-8621 Ph: (636) 244-2080 | Monticello Sleep Dentistry LLC 530 Huber Park Ct Ste 201 Weldon Spring MO 63304-8621 Ph: (636) 244-2080 |
| NPI Number | 1053273482 |
|---|---|
| Provider Enumeration Date | 11/24/2025 |
| Last Update Date | 11/24/2025 |
| Certification Date | 11/24/2025 |
| Medicare PECOS PAC ID | 7911480900 |
|---|---|
| Medicare Enrollment ID | O20260309000405 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053273482 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | () | Primary |
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