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Organization

JEFFERSON COUNTY HEALTH DEPARTMET

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RYANN LEE SUMMERFORD BS (DENTAL PROGRAM COORDINATOER)
(636) 282-1010
Entity
Organization

Contact information

Practice address
1818 LONEDELL RD, ARNOLD, MO 63010-1050
(636) 282-1010
(636) 282-2525
Mailing address
1818 LONEDELL RD, ARNOLD, MO 63010-1050
(636) 282-1010
(636) 282-2525

Taxonomy

Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
16116011
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
002932
HYGIENIST STATE LICENCE
MO
Enumeration date
02/09/2007
Last updated
08/23/2007
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