Organization
GATEWAY ORAL AND MAXILLOFACIAL SURGEONS OF ST LOUIS, P.C.
Active
Organization
GATEWAY ORAL AND MAXILLOFACIAL SURGEONS OF ST LOUIS, P.C.
Active
Other names
Travis & Nolen Oral & Maxillofacial Surgery, P.C.
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DAUN M. BRANDT (BUSINESS MANAGER)
(314) 726-2755
Entity
Organization
Contact information
Practice address
165 N. MERAMEC AVE, SUITE 300, CLAYTON, MO 63105-3772
(314) 726-2755
(314) 726-9538
Mailing address
165 N. MERAMEC AVE, SUITE 300, CLAYTON, MO 63105-3772
(314) 726-2755
(314) 726-9538
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
12435
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
990001492
MEDICARE GROUP ID
MO
Enumeration date
02/13/2008
Last updated
04/11/2023
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up