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General NPI Number Information
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NPI Number | 1831561273
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Entity Type | Organization
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Legal Business Name | LIFETIME DENTAL CARE OF MISSOURI, RICHARD STRAUS, D.M.D., P.C.
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Dates
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Enumeration Date | 10/26/2015
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Last Update Date | 05/12/2025
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Provider Practice Location Address
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Address Line | 11 WENTZVILLE BLUFFS DR STE 101
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City | WENTZVILLE
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State | MO
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Zip | 63385-4534
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Country | US
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Telephone | 636-445-3770
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Fax | 636-445-3764
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Provider Business Mailing Address
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Address Line | 11 WENTZVILLE BLUFFS DR STE 101
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City | WENTZVILLE
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State | MO
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Zip | 63385-4534
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Country | US
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Telephone | 636-445-3770
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Fax | 636-445-3764
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Authorized Official
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Title or Position | CREDENTIALING COORDINATOR
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Name | CELIA HAYES
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Credential |
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Telephone | 217-540-2100
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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 |
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License Number State |
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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 |
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License Number State |
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