# GATEWAY ORAL AND MAXILLOFACIAL SURGEONS OF ST LOUIS, P.C.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Travis & Nolen Oral & Maxillofacial Surgery, P.C.
- **Organization subpart:** No

## Provider details

- **NPI number:** 1184892028
- **Authorized official:** MRS. DAUN M. BRANDT (BUSINESS MANAGER)
- **Authorized official phone:** (314) 726-2755

## Contact information

- **Practice address:** 165 N. MERAMEC AVE, SUITE 300, CLAYTON, MO 63105-3772
- **Practice address phone:** (314) 726-2755
- **Practice address fax:** (314) 726-9538
- **Mailing address:** 165 N. MERAMEC AVE, SUITE 300, CLAYTON, MO 63105-3772
- **Mailing address phone:** (314) 726-2755
- **Mailing address fax:** (314) 726-9538

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 12435 | MO | Yes |

## Other

- **Enumeration date:** 02/13/2008
- **Last updated:** 04/11/2023