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General NPI Number Information
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NPI Number | 1487564266
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Entity Type | Organization
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Legal Business Name | LUKE R. KOMOTOS LLC
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Dates
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Enumeration Date | 09/11/2026
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Last Update Date | 09/11/2026
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Provider Practice Location Address
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Address Line | 2008 E 5TH ST STE 1
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City | WASHINGTON
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State | MO
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Zip | 63090-3626
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Country | US
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Telephone | 314-960-7160
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Fax |
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Provider Business Mailing Address
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Address Line | 2008 E 5TH ST STE 1
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City | WASHINGTON
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State | MO
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Zip | 63090-3626
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DR. LUKE KOMOTOS
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Credential | DDS
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Telephone | 314-960-7160
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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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