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General NPI Number Information
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NPI Number | 1366657405
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Entity Type | Organization
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Legal Business Name | STEVEN J. HRIBERNIK, D.M.D., P.C.
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Dates
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Enumeration Date | 05/11/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1155 E GANNON DR
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City | FESTUS
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State | MO
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Zip | 63028-2611
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Country | US
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Telephone | 636-931-4699
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Fax | 636-931-5110
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Provider Business Mailing Address
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Address Line | 1155 E GANNON DR
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City | FESTUS
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State | MO
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Zip | 63028-2611
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Country | US
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Telephone | 636-931-4699
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Fax | 636-931-5110
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. PEGGY S. CAROTHERS
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Credential |
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Telephone | 314-842-4699
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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 | 015277
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License Number State | MO
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