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Individual

MARTIN KEVIN ERESH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
1412-A OLD GRAVOIS RD, HIGH RIDGE, MO 63049
(636) 343-8990
Mailing address
1412-A OLD GRAVOIS RD, HIGH RIDGE, MO 63049
(636) 343-8990

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12698
MO

Other

Enumeration date
09/13/2011
Last updated
09/13/2011
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