Healthcare Provider Details

I. General information

NPI: 1477293496
Provider Name (Legal Business Name): NUSET ST. LOUIS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/29/2022
Last Update Date: 03/29/2022
Certification Date: 03/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2821 N BALLAS RD STE 225
SAINT LOUIS MO
63131-2378
US

IV. Provider business mailing address

7991 VANCE DR STE A
ARVADA CO
80003-2148
US

V. Phone/Fax

Practice location:
  • Phone: 314-569-1012
  • Fax:
Mailing address:
  • Phone: 303-422-2990
  • Fax: 303-425-4386

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: ROBERT RYAN
Title or Position: OWNER
Credential: MD/DDS
Phone: 303-501-2212