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General NPI Number Information
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NPI Number | 1942189204
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Entity Type | Organization
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Legal Business Name | LITTLE PEARLS PEDIATRIC DENTISTRY LLC
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Dates
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Enumeration Date | 08/30/2025
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Last Update Date | 08/30/2025
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Provider Practice Location Address
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Address Line | 1001 BRITTANY PKWY UNIT F-1
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City | MANCHESTER
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State | MO
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Zip | 63011-4325
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Country | US
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Telephone | 314-343-1037
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Fax |
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Provider Business Mailing Address
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Address Line | 605 RUE MONTAND DR
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City | BALLWIN
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State | MO
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Zip | 63011-2808
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Country | US
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Telephone | 314-910-0156
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MARY MARGARET KRATZ
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Credential | DDS
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Telephone | 314-910-0156
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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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