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General NPI Number Information
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NPI Number | 1225183692
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Entity Type | Organization
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Legal Business Name | MIDPOINT DENTAL, LLC
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Dates
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Enumeration Date | 01/24/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2885 HIGHWAY K
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City | O FALLON
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State | MO
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Zip | 63368-7863
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Country | US
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Telephone | 636-272-6482
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Fax | 636-272-6485
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Provider Business Mailing Address
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Address Line | 2885 HIGHWAY K
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City | O FALLON
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State | MO
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Zip | 63368-7863
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Country | US
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Telephone | 636-272-6482
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Fax | 636-272-6485
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | DR. JOHN KEATING SILBERBERG
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Credential | D.D.S.
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Telephone | 636-561-2124
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 13929
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License Number State | MO
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