MEDICARE: DR. ROBERT THOMURE D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	13361	MO

General Provider Information

NPI Number	:	1184637969
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT THOMURE D.D.S.

Provider Business Mailing Address
First Line	:	11166 TESSON FERRY RD
Second Line	:	SUITE 210
City	:	SAINT LOUIS
State	:	MO
Zip	:	63123-6966
Country	:	US
Telephone Number	:	314-842-6666
Fax Number	:	314-842-6676

Provider Business Practice Location Address
First Line	:	11166 TESSON FERRY RD
Second Line	:	SUITE 210
City	:	SAINT LOUIS
State	:	MO
Zip	:	63123-6966
Country	:	US
Telephone Number	:	314-842-6666
Fax Number	:	314-842-6676

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/14/2006
Last Update Date	:	07/08/2007

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