Organization
MCLEOD PERIODONTICS
Active
Parent organization
MCLEOD PERIODONTICS
Organization subpart
Yes
Provider details
NPI number
Legal business name
MCLEOD PERIODONTICS
Authorized official
DR. DWIGHT E. MCLEOD DDS (OWNER)
(314) 731-1700
Entity
Organization
Contact information
Practice address
5992 HOWDERSHELL RD, SUITE 204, HAZELWOOD, MO 63042-4107
(314) 731-1700
(314) 731-1784
Mailing address
5992 HOWDERSHELL RD., SUITE 204, HAZELWOOD, MISSOURI 63042
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
015787
MO
Other
Enumeration date
11/21/2008
Last updated
11/21/2008
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