Organization
SIMONE FAVOR DDS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINE BARBER (PROVIDER ENROLLMENT)
(315) 454-6000
Entity
Organization
Contact information
Practice address
4016 LEMAY FERRY RD, SAINT LOUIS, MO 63129-1858
(314) 627-0209
(314) 894-5534
Mailing address
PO BOX 70887, CLEVELAND, OH 44190-0887
(315) 454-6000
(315) 410-5531
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
03/18/2025
Last updated
03/18/2025
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