# DANNY M GENNAOUI DMD LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Gennaoui Family Dental
- **Organization subpart:** No

## Provider details

- **NPI number:** 1417612904
- **Authorized official:** TARA REES (TREATMENT COORDINATOR)
- **Authorized official phone:** (314) 821-4410

## Contact information

- **Practice address:** 3701 S LINDBERGH BLVD STE 200, SAINT LOUIS, MO 63127-1372
- **Practice address phone:** (314) 821-4410
- **Mailing address:** 3701 S LINDBERGH BLVD STE 200, SAINT LOUIS, MO 63127-1372
- **Mailing address phone:** (314) 821-4410

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 11/01/2021
- **Last updated:** 11/01/2021