La Juana Delise Bragdon in Florissant - Dentist
La Juana Delise Bragdon - NPI 1912034687
La Juana Delise Bragdon is a Dentist in Florissant, Missouri. La Juana Delise Bragdon practices all healthcare services and medical treatments related to Dentist. The NPI Number for La Juana Delise Bragdon is 1912034687. The last update date is 2008-07-30.
La Juana Delise Bragdon's current location address is 1934 Suns Up Way, Florissant, Missouri. You can contact this provider via phone number 3148302004. The mailing address for La Juana Delise Bragdon is 1934 Suns Up Way, Florissant, Missouri. To know further, please read the information below!
Provider Profile Detail
| Provider Name | La Juana Delise Bragdon |
|---|---|
| Address | 1934 Suns Up Way, Florissant, Missouri |
| Phone Number | 3148302004 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | DDS |
NPI Number Detail
| NPI Number | 1912034687 |
|---|---|
| Provider Enumeration Date | 2007-02-28 |
| Last Updated Date | 2008-07-30 |
Provider Mailing Address Detail
| Address | 1934 Suns Up Way |
|---|---|
| City | Florissant |
| State | Missouri (MO) |
| Post Code | 63031 |
| Phone Number | 3148302004 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Dentist |
|---|---|
| Taxonomy | 122300000X |
| Licence No | 15977 |
|
Definition: A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: denti |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 403864614 | MO | -- |
Post Comment/ Review Below
What is the unique identification code assigned to La Juana Delise Bragdon by the Centers for Medicare & Medicaid Services?
The La Juana Delise Bragdon has been issued the NPI (National Provider Identifier) 1912034687. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Can you provide the La Juana Delise Bragdon's physical address?
The La Juana Delise Bragdon is physically located at 1934 Suns Up Way, in the city of Florissant, MO, with the postal code 63031.
What is the La Juana Delise Bragdon's specialty and taxonomy code?
The La Juana Delise Bragdon's specialty is Dentist, and the corresponding taxonomy code is 122300000X.
On what date did the La Juana Delise Bragdon receive the assignment of its 1912034687 from the Centers for Medicare & Medicaid Services?
The La Juana Delise Bragdon was issued its 1912034687 by the Centers for Medicare & Medicaid Services on 2007-02-28.
As of what date were the La Juana Delise Bragdon's details last updated?
The information pertaining to the La Juana Delise Bragdon, including its address, specialty, and other details, was most recently updated on 2008-07-30.
NPI Number: 1568460681
Address: 830 S. Addison Avenue, Villa Park, IL
NPI Number: 1922080514
Address: 2245 Plantation Center Dr Ste 57, Fleming Island, FL