Boulevard Dental Care L.L.C. in Des Peres - General Practice
Boulevard Dental Care L.L.C. - NPI 1831247048
Boulevard Dental Care L.L.C. is a General Practice in Des Peres, Missouri. Boulevard Dental Care L.L.C. practices all healthcare services and medical treatments related to General Practice. The NPI Number for Boulevard Dental Care L.L.C. is 1831247048. The last update date is 2007-07-30.
Boulevard Dental Care L.L.C.'s current location address is 11939 Manchester Rd, Des Peres, Missouri. You can contact this provider via phone number 6369396868 and fax number 6364473611. The mailing address for Boulevard Dental Care L.L.C. is 11939 Manchester Rd, Des Peres, Missouri. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Boulevard Dental Care L.L.C. |
|---|---|
| Address | 11939 Manchester Rd, Des Peres, Missouri |
| Phone Number | 6369396868 |
| Fax Number | 6364473611 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | MANAGER |
|---|---|
| Authorized Official Name | Reyes Craig Randall |
| Credentials | D.M.D. |
| Telephone Number | 6369396868 |
NPI Number Detail
| NPI Number | 1831247048 |
|---|---|
| Provider Enumeration Date | 2007-01-07 |
| Last Updated Date | 2007-07-30 |
Provider Mailing Address Detail
| Address | 11939 Manchester Rd |
|---|---|
| City | Des Peres |
| State | Missouri (MO) |
| Post Code | 631314502 |
| Phone Number | 6369396868 |
| Fax Number | 6364473611 |
Provider's Primary Taxonomy Detail
| Speciality | General Practice |
|---|---|
| Taxonomy | 1223G0001X |
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Definition: A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
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What is the unique 10-digit identification code assigned to Boulevard Dental Care L.L.C. by the Centers for Medicare & Medicaid Services?
The Boulevard Dental Care L.L.C. has been issued the NPI (National Provider Identifier) 1831247048, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you share the physical location details of Boulevard Dental Care L.L.C.?
The Boulevard Dental Care L.L.C. is situated at 11939 Manchester Rd, in the city of Des Peres, state of MO, with the zip code 631314502.
What is Boulevard Dental Care L.L.C.'s specialized field of practice, and what is the corresponding taxonomy classification code?
The Boulevard Dental Care L.L.C.'s area of specialization is General Practice, and the corresponding taxonomy code that categorizes this field of practice is 1223G0001X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1831247048 to Boulevard Dental Care L.L.C.?
The Centers for Medicare & Medicaid Services originally issued the 1831247048 to Boulevard Dental Care L.L.C. on 2007-01-07.
When was the information related to Boulevard Dental Care L.L.C. most recently updated or refreshed?
The details pertaining to the Boulevard Dental Care L.L.C., including its address, specialty, and other relevant information, were last updated or refreshed on 2007-07-30.