Organization
DAVID GUILBEAULT DMD THREE RIVERS DENTAL LLC
Active
Other names
Three Rivers Dental
Organization subpart
No
Provider details
NPI number
Authorized official
AMY GIBBONS (OPERATIONS MANAGER)
(618) 248-2038
Entity
Organization
Contact information
Practice address
2386 N HIGHWAY 67, SUITE 2, FLORISSANT, MO 63033-2034
(314) 355-4140
Mailing address
24 GINGER CREEK PKWY, GLEN CARBON, IL 62034-3502
(618) 248-3463
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2000174030
MO
Other
Enumeration date
05/17/2013
Last updated
02/24/2014
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