Terry Egan Dds Llc in Bridgeton - Periodontics
Terry Egan Dds Llc - NPI 1558578187
Terry Egan Dds Llc is a Periodontics in Bridgeton, Missouri. Terry Egan Dds Llc practices all healthcare services and medical treatments related to Periodontics. The NPI Number for Terry Egan Dds Llc is 1558578187. The last update date is 2020-08-22.
Terry Egan Dds Llc's current location address is 12758 Boenker Ln, Bridgeton, Missouri. You can contact this provider via phone number 3147393300. The mailing address for Terry Egan Dds Llc is 12758 Boenker Ln, Bridgeton, Missouri. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Terry Egan Dds Llc |
|---|---|
| Address | 12758 Boenker Ln, Bridgeton, Missouri |
| Phone Number | 3147393300 |
| Fax Number | |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | MANAGER |
|---|---|
| Authorized Official Name | Egan R Terry |
| Credentials | DDS |
| Telephone Number | 3147393300 |
NPI Number Detail
| NPI Number | 1558578187 |
|---|---|
| Provider Enumeration Date | 2007-05-16 |
| Last Updated Date | 2020-08-22 |
Provider Mailing Address Detail
| Address | 12758 Boenker Ln |
|---|---|
| City | Bridgeton |
| State | Missouri (MO) |
| Post Code | 630442436 |
| Phone Number | 3147393300 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Periodontics |
|---|---|
| Taxonomy | 1223P0300X |
| Licence No | 14516 |
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Definition: That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structure |
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What is the unique identifier code issued to Terry Egan Dds Llc by the Centers for Medicare & Medicaid Services?
The Terry Egan Dds Llc has been assigned the NPI (National Provider Identifier) 1558578187. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Could you please share the complete physical location address where Terry Egan Dds Llc's facilities are situated?
The facilities of Terry Egan Dds Llc are physically located at the following address: 12758 Boenker Ln, Bridgeton, MO, 630442436.
What is Terry Egan Dds Llc's primary area of medical expertise, and what taxonomy classification code corresponds to this specialized field?
The primary area of medical expertise for Terry Egan Dds Llc is Periodontics, and the corresponding taxonomy classification code for this specialized field is 1223P0300X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1558578187 to Terry Egan Dds Llc?
The Centers for Medicare & Medicaid Services originally issued the 1558578187 to Terry Egan Dds Llc on 2007-05-16.
When was the information pertaining to Terry Egan Dds Llc most recently updated or revised?
The details related to Terry Egan Dds Llc, including its address, specialty, and other relevant information, were last updated or revised on 2020-08-22.