Individual
TUAN THAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
12221 SAINT CHARLES ROCK RD, BRIDGETON, MO 63044-2502
(314) 656-6615
Mailing address
4910 W PINE BLVD APT 511, SAINT LOUIS, MO 63108-1989
(415) 846-0684
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2019024063
MO
Other
Enumeration date
07/02/2019
Last updated
07/02/2019
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