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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