Individual
COREY HASTINGS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS, MS
Contact information
Practice address
3320 RUTGER ST, SAINT LOUIS, MO 63104
(314) 977-8363
Mailing address
14 BRIARWICK TRL, SAINT PETERS, MO 63376-3370
(314) 496-3562
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
2018004249
MO
122300000X
Dentist
30024956
OH
1223P0221X
Pediatric Dentistry
Primary
2018004249
MO
Other
Enumeration date
02/03/2016
Last updated
02/01/2020
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