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General NPI Number Information
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NPI Number | 1790338168
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Entity Type | Individual
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Provider Name | CORBIN SALTHOUSE DDS
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Gender | Male
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Dates
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Enumeration Date | 07/24/2019
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Last Update Date | 11/01/2022
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Provider Practice Location Address
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Address Line | 11941 MANCHESTER RD
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City | DES PERES
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State | MO
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Zip | 63131-4502
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Country | US
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Telephone | 314-804-5437
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Fax |
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Provider Business Mailing Address
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Address Line | 1314 TURTLE CV
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City | BALLWIN
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State | MO
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Zip | 63011-4249
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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 |
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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 | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 30025875
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 2021020458
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 61920
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License Number State | KS
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