Healthcare Provider Details

I. General information

NPI: 1487155925
Provider Name (Legal Business Name): GATEWAY DENTAL GROUP SCHREINER DDS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2018
Last Update Date: 02/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7171 DELMAR BLVD STE 201
ST LOUIS MO
63130
US

IV. Provider business mailing address

18009 TARA WOODS COURT
CHESTERFIELD MO
63095
US

V. Phone/Fax

Practice location:
  • Phone: 314-721-5551
  • Fax:
Mailing address:
  • Phone: 314-721-5551
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. REBECCA F SCHREINER
Title or Position: MEMBER
Credential: DDS
Phone: 314-518-1088