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General NPI Number Information
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NPI Number | 1871467282
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Entity Type | Organization
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Legal Business Name | HASTINGS AND WAITE LLC
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Dates
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Enumeration Date | 09/30/2025
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Last Update Date | 09/30/2025
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Provider Practice Location Address
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Address Line | 8500 MARYLAND AVE APT 624
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City | CLAYTON
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State | MO
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Zip | 63124-2316
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Country | US
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Telephone | 314-956-0528
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Fax |
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Provider Business Mailing Address
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Address Line | 8500 MARYLAND AVE APT 624
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City | CLAYTON
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State | MO
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Zip | 63124-2316
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Country | US
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Telephone | 314-956-0528
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Fax |
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Authorized Official
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Title or Position | PEDIATRIC DENTIST
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Name | DR. MATTHEW WAITE
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Credential | DDS, MPH, MSD
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Telephone | 314-956-0528
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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 |
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License Number State |
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