Organization
PARKER ROUSTIO DMD INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PARKER ROUSTIO DMD (OWNER)
(618) 628-7080
Entity
Organization
Contact information
Practice address
1002 E WESLEY DR STE 200, O FALLON, IL 62269-6143
(618) 628-7080
(618) 628-9235
Mailing address
1002 E WESLEY DR STE 200, O FALLON, IL 62269-6143
(618) 628-7080
(618) 628-9235
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
12/01/2025
Last updated
12/01/2025
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