Numpol Dejtiranukul Dmd Llc Valid NPI
Organization · General Practice Dentistry · O Fallon, MO
- NPI
- 1043479215
- Type
- Organization (Type 2)
- Primary specialty
- General Practice Dentistry (Dentist)
- Specialty group
- Dental Providers
- Taxonomy code
- 1223G0001X
- License number
- 2000170243 (MO)
- Enumerated
- 2008-06-03
- Last updated
- 2008-06-03
Practice location
4122 Keaton Crossing Blvd, Suite 101
O Fallon, MO 63368-8218
(636) 300-4280