Organization
MDP OF MISSOURI LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY REIBEL (CFO)
(502) 254-8500
Entity
Organization
Contact information
Practice address
811 HAZELWEST DR, HAZELWOOD, MO 63042-1749
(314) 731-7555
Mailing address
PO BOX 437169, LOUISVILLE, KY 40253-7169
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
11/19/2025
Last updated
11/20/2025
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