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General NPI Number Information
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NPI Number | 1215919246
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Entity Type | Individual
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Provider Name | BRIAN R OGLANDER D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/16/2005
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Last Update Date | 09/22/2011
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Provider Practice Location Address
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Address Line | 10000 WATSON RD SUITE A
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City | SAINT LOUIS
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State | MO
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Zip | 63126-1854
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Country | US
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Telephone | 314-822-3322
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Fax | 314-822-0537
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Provider Business Mailing Address
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Address Line | 10000 WATSON RD SUITE A
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City | SAINT LOUIS
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State | MO
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Zip | 63126-1854
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Country | US
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Telephone | 314-822-3322
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Fax | 314-822-0537
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 016063
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License Number State | MO
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