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General NPI Number Information
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NPI Number | 1174728422
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Entity Type | Organization
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Legal Business Name | CARY W. ULBRICH, DDS, LLC
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Dates
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Enumeration Date | 06/18/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 308 NOONAN DR SUITE E
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City | PACIFIC
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State | MO
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Zip | 63069-1118
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Country | US
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Telephone | 636-257-5155
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Fax | 636-257-5255
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Provider Business Mailing Address
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Address Line | 308 NOONAN DR SUITE E
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City | PACIFIC
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State | MO
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Zip | 63069-1118
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Country | US
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Telephone | 636-257-5155
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Fax | 636-257-5255
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Authorized Official
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Title or Position | OWNER
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Name | DR. CARY W ULBRICH
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Credential | DDS
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Telephone | 636-257-5155
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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 | DE015174
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License Number State | MO
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