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General NPI Number Information
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NPI Number | 1407749088
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Entity Type | Organization
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Legal Business Name | SKYVIEW PEDIATRIC DENTISTRY-GT
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Dates
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Enumeration Date | 06/02/2025
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Last Update Date | 06/02/2025
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Provider Practice Location Address
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Address Line | 10049 MANCHESTER RD
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City | SAINT LOUIS
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State | MO
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Zip | 63122-1825
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Country | US
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Telephone | 314-671-4019
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Fax |
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Provider Business Mailing Address
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Address Line | 13001 N OUTER 40 RD STE 360
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City | TOWN AND COUNTRY
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State | MO
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Zip | 63017-5941
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Country | US
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Telephone | 314-626-4579
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | EMILY HAHN
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Credential | DDS
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Telephone | 618-210-8323
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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 |
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License Number State |
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