Organization
DANNY M GENNAOUI DMD LLC
Active
Other names
Gennaoui Family Dental
Organization subpart
No
Provider details
NPI number
Authorized official
TARA REES (TREATMENT COORDINATOR)
(314) 821-4410
Entity
Organization
Contact information
Practice address
3701 S LINDBERGH BLVD STE 200, SAINT LOUIS, MO 63127-1372
(314) 821-4410
Mailing address
3701 S LINDBERGH BLVD STE 200, SAINT LOUIS, MO 63127-1372
(314) 821-4410
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1518214782
NPI TYPE 1
—
Enumeration date
11/01/2021
Last updated
11/01/2021
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