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General NPI Number Information
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NPI Number | 1154541282
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Entity Type | Organization
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Legal Business Name | MISSOURI DENTAL PROFESSIONALS, RICHARD STRAUS, DMD, PC
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Dates
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Enumeration Date | 04/30/2007
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Last Update Date | 10/03/2024
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Provider Practice Location Address
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Address Line | 956 BRYAN RD
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City | O FALLON
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State | MO
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Zip | 63366-3800
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Country | US
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Telephone | 636-272-3503
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Fax | 636-272-3504
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Provider Business Mailing Address
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Address Line | 956 BRYAN RD
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City | O FALLON
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State | MO
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Zip | 63366-3800
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Country | US
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Telephone | 636-272-3503
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Fax | 636-272-3504
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Authorized Official
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Title or Position | CRED COORDINATOR
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Name | HILLARY THULL
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Credential |
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Telephone | 217-540-8946
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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