Individual
MARSHALL CORNELIUS FREERKS JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
6744 CLAYTON RD., SUITE 204, ST. LOUIS, MO 63117-1634
(314) 725-5515
Mailing address
6744 CLAYTON RD., SUITE 204, ST. LOUIS, MO 63117-1634
(314) 725-5515
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
14600
MO
261QD0000X
Dental Clinic/Center
Primary
14600
MO
Other
Enumeration date
01/30/2009
Last updated
01/30/2009
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