MEDICARE: MARIO FRANCO-DI TORE DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	2024018190	MO

General Provider Information

NPI Number	:	1578303954
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIO FRANCO-DI TORE DMD

Provider Business Mailing Address
First Line	:	7553 PARKDALE AVE APT 2S
Second Line	:
City	:	CLAYTON
State	:	MO
Zip	:	63105-2813
Country	:	US
Telephone Number	:	419-460-3258
Fax Number	:

Provider Business Practice Location Address
First Line	:	3708 JENNINGS STATION RD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63121-3500
Country	:	US
Telephone Number	:	314-382-2000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/31/2024
Last Update Date	:	06/11/2024

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Directions to “ MARIO FRANCO-DI TORE DMD” Practice Location

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