Parker Roustio, DMD Valid NPI
Individual provider · General Practice Dentistry · O Fallon, IL
- NPI
- 1841976842
- Type
- Individual (Type 1)
- Primary specialty
- General Practice Dentistry (Dentist)
- Specialty group
- Dental Providers
- Taxonomy code
- 1223G0001X
- License number
- 019.034489 (IL)
- Sex
- Male
- Sole proprietor
- No
- Enumerated
- 2023-06-23
- Last updated
- 2025-04-09
Practice location
1002 E Wesley Dr Ste 200
O Fallon, IL 62269-6143
(618) 628-7080