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General NPI Number Information
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NPI Number | 1396918140
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Entity Type | Organization
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Legal Business Name | NICHOLAS P KAMAKAS, DDS
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Dates
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Enumeration Date | 04/11/2008
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Last Update Date | 03/24/2015
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Provider Practice Location Address
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Address Line | 1167 REMLEY CT
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City | SAINT LOUIS
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State | MO
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Zip | 63130-2135
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Country | US
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Telephone | 314-727-7435
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Fax | 314-727-7003
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Provider Business Mailing Address
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Address Line | 1167 REMLEY CT
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City | SAINT LOUIS
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State | MO
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Zip | 63130-2135
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Country | US
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Telephone | 314-727-7435
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Fax | 314-727-7003
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Authorized Official
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Title or Position | OWNER
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Name | DR. NICHOLAS P KAMAKAS
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Credential |
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Telephone | 314-727-7435
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 010913
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 12839
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License Number State | MO
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