Organization
GATEWAY ORAL HEALTH FOUNDATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BYRON V DEVALL DDS (DENTIST)
(314) 872-3930
Entity
Organization
Contact information
Practice address
9378 OLIVE ST STE ILL, GATEWAY ORAL HEALTH FOUNDATION, OLIVETTE, MO 63132-9378
(314) 872-3930
(314) 872-3952
Mailing address
9378 OLIVE ST STE ILL, OLIVETTE, MO 63132-9378
(314) 872-3930
(314) 872-3952
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
M0013419
MO
Other
Enumeration date
01/22/2007
Last updated
08/22/2020
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