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General NPI Number Information
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NPI Number | 1477840205
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Entity Type | Individual
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Provider Name | CYNTHIA ELAINE ULRICH D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 06/30/2011
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Last Update Date | 07/30/2013
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Provider Practice Location Address
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Address Line | 1333 W OUTER 21 RD
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City | ARNOLD
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State | MO
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Zip | 63010-3239
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Country | US
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Telephone | 636-333-3304
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Fax | 636-333-3307
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Provider Business Mailing Address
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Address Line | 1333 W OUTER 21 RD
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City | ARNOLD
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State | MO
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Zip | 63010-3239
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Country | US
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Telephone | 636-333-3304
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Fax | 636-333-3307
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 2011015405
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License Number State | MO
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