Individual
NICHOLAS BERKENBILE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
14649 MANCHESTER RD, BALLWIN, MO 63011-3745
(636) 431-5280
Mailing address
7400 SUTHERLAND AVE, SAINT LOUIS, MO 63119-2851
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2024021261
MO
Other
Enumeration date
06/19/2024
Last updated
06/19/2024
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