Organization
16111 MANCHESTER ROAD, L.L.C.
Active
Other names
Zieba Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES M. ZIEBA DMD (DENTIST/OWNER)
(636) 391-6030
Entity
Organization
Contact information
Practice address
428 OLD STATE RD., ELLISVILLE, MO 63021
(636) 391-6030
(636) 527-8386
Mailing address
428 OLD STATE RD., ELLISVILLE, MO 63021
(636) 391-6030
(636) 527-8386
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
2000165488
MO
1223G0001X
General Practice Dentistry
Primary
2000169958
MO
Other
Enumeration date
09/15/2015
Last updated
09/15/2015
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