Healthcare Provider Details

I. General information

NPI: 1194883934
Provider Name (Legal Business Name): LEVITT AND APPELBAUM, D.M.D., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2006
Last Update Date: 10/02/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2050 BLUESTONE DR
SAINT CHARLES MO
63303-5977
US

IV. Provider business mailing address

2050 BLUESTONE DR
SAINT CHARLES MO
63303-5977
US

V. Phone/Fax

Practice location:
  • Phone: 636-946-5225
  • Fax: 636-946-5005
Mailing address:
  • Phone: 636-946-5225
  • Fax: 636-946-5005

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number014073
License Number StateMO

VIII. Authorized Official

Name: DR. MURRAY H. APPELBAUM
Title or Position: VICE PRESIDENT
Credential: D.M.D.
Phone: 636-946-5225