| St. Louis South Oral Surgery | |
|
9911 Kennerly Rd Suite E Saint Louis MO 63128-2700 | |
| (314) 842-4699 | |
| (314) 842-3074 |
| Full Name | St. Louis South Oral Surgery |
|---|---|
| Speciality | Dentist |
| Location | 9911 Kennerly Rd, Saint Louis, Missouri |
| Authorized Official Name and Position | Dana M Poppe (PRACTICE ADMINISTRATOR) |
| Authorized Official Contact | 3148424699 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| St. Louis South Oral Surgery 9911 Kennerly Rd Suite E Saint Louis MO 63128-2700 Ph: (314) 842-4699 | St. Louis South Oral Surgery 9911 Kennerly Rd Suite E Saint Louis MO 63128-2700 Ph: (314) 842-4699 |
| NPI Number | 1336365956 |
|---|---|
| Provider Enumeration Date | 04/18/2007 |
| Last Update Date | 06/30/2023 |
| Medicare PECOS PAC ID | 3870835788 |
|---|---|
| Medicare Enrollment ID | O20190424003230 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336365956 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
| Provider Name | William A Gray |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1205047933 PECOS PAC ID: 6800041302 Enrollment ID: I20130307000518 |
| Provider Name | Jason Buschman |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1891720728 PECOS PAC ID: 6901060763 Enrollment ID: I20191122000710 |
Joseph And Nina Zeigler, D.m.d.s, P.c. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2821 N Ballas Rd, Suite 200, Saint Louis, MO 63131 Phone: 314-872-7590 | |
Jason L Allen Dmd Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 5147 Daggett Ave, Saint Louis, MO 63110 Phone: 314-776-7800 | |
Deborah Long Coon Dmd Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 950 Francis Pl, Ste 302, Saint Louis, MO 63105 Phone: 314-726-5553 Fax: 314-726-6663 | |
Missouri Dental Professionals, Richard Straus, D.m.d., P.c. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1544 Sierra Vista Plz, Saint Louis, MO 63138 Phone: 314-355-5700 | |
Garden Heights Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1608 S Big Bend Blvd, Saint Louis, MO 63117 Phone: 314-645-1225 | |
Carestl Health Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 4500 Pope Ave, Saint Louis, MO 63115 Phone: 314-385-3990 Fax: 314-389-2464 | |
Thomas Kennedy, Dds Of Missouri Ii, Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 9960 Kennerly Rd Ste B, Saint Louis, MO 63128 Phone: 314-849-2760 |