Healthcare Provider Details
I. General information
NPI: 1326976283
Provider Name (Legal Business Name): FRONTENAC PEDIATRIC DENTISTRY OF ST. LOUIS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10401 CLAYTON RD STE 150
SAINT LOUIS MO
63131-2909
US
IV. Provider business mailing address
10401 CLAYTON RD STE 150
SAINT LOUIS MO
63131-2909
US
V. Phone/Fax
- Phone: 314-960-2198
- Fax:
- Phone: 314-960-2198
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223P0221X |
| Taxonomy | Pediatric Dentistry |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
EVAN
JAMES
REED
Title or Position: OWNER / PEDIATRIC DENTIST
Credential: D.D.S.
Phone: 314-960-2198