# STEPHEN W. HIATT DDS AND MARYANN L. UDY DMD PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** George T. Shuert DDS and Stephen W. Hiatt DDS PC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1336314079
- **Authorized official:** MRS. LANA S. WISNIEWSKI (BUSINESS MANAGER)
- **Authorized official phone:** (636) 978-6967

## Contact information

- **Practice address:** 2992 HIGHWAY K, STE 133, O FALLON, MO 63368-7861
- **Practice address phone:** (636) 978-6967
- **Practice address fax:** (636) 978-5905
- **Mailing address:** 5551 WINGHAVEN BLVD. STE. 210, O'FALLON, MO 63368
- **Mailing address phone:** (636) 978-6967
- **Mailing address fax:** (636) 978-5905

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 011813 | MO | Yes |

## Other

- **Enumeration date:** 04/24/2008
- **Last updated:** 06/28/2019