Organization
BANKHEAD DDS ORTHODONTICS DDS PC
Active
Organization
BANKHEAD DDS ORTHODONTICS DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DARREN MCKAY RODABORUGH DDS (OWNER)
(636) 978-8848
Entity
Organization
Contact information
Practice address
8631 STATE HIGHWAY N, LAKE ST. LOUIS, MO 63367
(636) 226-1050
(636) 898-2001
Mailing address
3006 HWY K, O'FALLON, MO 63368
(636) 978-8848
(636) 294-4059
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
06/14/2024
Last updated
06/14/2024
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