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General NPI Number Information
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NPI Number | 1295938157
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Entity Type | Organization
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Legal Business Name | PETER J SPALITTO, DDS, PC
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Dates
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Enumeration Date | 06/07/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 13268 MANCHESTER RD
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City | SAINT LOUIS
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State | MO
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Zip | 63131-1706
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Country | US
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Telephone | 314-821-2712
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Fax |
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Provider Business Mailing Address
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Address Line | 13268 MANCHESTER RD
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City | SAINT LOUIS
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State | MO
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Zip | 63131-1706
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Country | US
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Telephone | 314-821-2712
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PETER J SPALITTO
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Credential | D.D.S.
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Telephone | 314-821-2712
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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 | 2000157532
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License Number State | MO
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