| Numpol Dejtiranukul DMD LLC | |
|
4122 Keaton Crossing Blvd Suite 101 O Fallon MO 63368-8218 | |
| (636) 300-4280 | |
| Not Available |
| Full Name | Numpol Dejtiranukul DMD LLC |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 4122 Keaton Crossing Blvd, O Fallon, Missouri |
| Authorized Official Name and Position | Numpol Dejtiranukul (SINGLE MEMBER) |
| Authorized Official Contact | 6363004280 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Numpol Dejtiranukul DMD LLC 4122 Keaton Crossing Blvd Suite 101 O Fallon MO 63368-8218 Ph: (636) 300-4280 | Numpol Dejtiranukul DMD LLC 4122 Keaton Crossing Blvd Suite 101 O Fallon MO 63368-8218 Ph: (636) 300-4280 |
| NPI Number | 1043479215 |
|---|---|
| Provider Enumeration Date | 06/03/2008 |
| Last Update Date | 06/03/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043479215 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 2000170243 (Missouri) | Primary |
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Phoenix Village Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 9210 Phoenix Village Pkwy, O Fallon, MO 63368 Phone: 636-561-1154 Fax: 636-625-0855 |
River City Endodontics Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 113 Church St, O Fallon, MO 63366 Phone: 636-362-4040 Fax: 636-362-4141 |
Dr. Maryana Kirolos Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 310 E Elm St, O Fallon, MO 63366 Phone: 636-240-6858 Fax: 636-272-4278 |
Mooney Orthodontics Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 9018 Phoenix Pkwy, O Fallon, MO 63368 Phone: 636-970-4700 |
Brookside Family Dentistry Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 31 Ofallon Sq, O Fallon, MO 63366 Phone: 636-240-1750 |