Organization
MATT ST GEORGE INC
Active
Other names
St George Family Dental
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW ST GEORGE DDS (OWNER)
(573) 642-6904
Entity
Organization
Contact information
Practice address
603 NICHOLS ST, FULTON, MO 65251-2650
(573) 642-6904
(573) 642-7256
Mailing address
603 NICHOLS ST, FULTON, MO 65251-2650
(573) 642-6904
(573) 642-7256
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2008014167
MO
Other
Enumeration date
03/06/2017
Last updated
03/06/2017
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