Individual
RANDALL CRAIG REYES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
2645 MUEGGE RD, SAINT CHARLES, MO 63303-3145
(636) 939-6868
(636) 447-3611
Mailing address
11939 MANCHESTER RD, SUITE 120, DES PERES, MO 63131-4502
(636) 939-6868
(636) 447-3611
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
015761
MO
Other
Enumeration date
01/08/2007
Last updated
07/08/2007
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