# SHAW PARK DENTAL LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1578497426
- **Authorized official:** DIPALI THAKKER (MANAGING MEMBER)
- **Authorized official phone:** (618) 558-2510

## Contact information

- **Practice address:** 225 S MERAMEC AVE STE 311, SAINT LOUIS, MO 63105-3511
- **Practice address phone:** (314) 727-2420
- **Mailing address:** 501 EISENHOWER BLVD, TROY, IL 62294-3341

## Taxonomy

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

## Other

- **Enumeration date:** 06/08/2026
- **Last updated:** 06/08/2026