Individual
DR. DUANE A DILWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
6121 N HANLEY RD, SAINT LOUIS, MO 63134-2003
(314) 615-0877
(314) 615-8303
Mailing address
6121 N HANLEY RD, SAINT LOUIS, MO 63134-2003
(314) 615-0877
(314) 615-8303
Taxonomy
Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
Primary
014675
MO
1223G0001X
General Practice Dentistry
014675
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
014675
MO LICENSEE
MO
Enumeration date
04/09/2008
Last updated
03/04/2013
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