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General NPI Number Information
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NPI Number | 1306343488
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Entity Type | Organization
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Legal Business Name | ASHOK K ROHRA JR DDS , LLC
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Dates
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Enumeration Date | 04/06/2018
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Last Update Date | 04/06/2018
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Provider Practice Location Address
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Address Line | 11255 OLIVE BLVD STE 200
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City | CREVE COEUR
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State | MO
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Zip | 63141-7652
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Country | US
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Telephone | 314-624-9373
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Fax |
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Provider Business Mailing Address
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Address Line | 11255 OLIVE BLVD STE 200
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City | CREVE COEUR
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State | MO
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Zip | 63141-7652
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Country | US
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Telephone | 314-624-9373
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Fax |
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Authorized Official
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Title or Position | ORTHODONTIST
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Name | DR. ASHOK K ROHRA JR.
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Credential | DDS , MSD
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Telephone | 314-624-9373
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 2018000319
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License Number State | MO
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