Organization
NIKODEM DENTAL HOLDINGS
Active
Parent organization
NIKODEM DENTAL HOLDINGS
Other names
Nikodem Dental Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
NIKODEM DENTAL HOLDINGS
Authorized official
DR. RAYMOND G NIKODEM DDS (PRESIDENT)
(314) 732-4591
Entity
Organization
Contact information
Practice address
4337 BUTLER HILL RD SUITE G, ST LOUIS MO, MO 63128
(314) 892-2000
(314) 892-4550
Mailing address
4337 BUTLER HILL RD SUITE L, ST LOUIS, MO 63128
(314) 732-4591
(314) 200-9691
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
02/12/2019
Last updated
02/12/2019
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