Healthcare Provider Details

I. General information

NPI: 1811070469
Provider Name (Legal Business Name): WM. GERALD ALBRECHT, DDS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2006
Last Update Date: 06/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3555 SUNSET OFFICE DR SUITE 210
SAINT LOUIS MO
63127-1015
US

IV. Provider business mailing address

3555 SUNSET OFFICE DR SUITE 210
SAINT LOUIS MO
63127-1015
US

V. Phone/Fax

Practice location:
  • Phone: 314-822-2764
  • Fax: 314-822-5758
Mailing address:
  • Phone: 314-822-2764
  • Fax: 314-822-5758

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. WILLIAM GERALD ALBRECHT
Title or Position: DOCTOR
Credential: D.D.S. P.C.
Phone: 314-822-2764