Organization
ST. LOUIS CHILDREN'S HOSPITAL
Active
Other names
St. Louis Children's Hospital Dental Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TRISHA LOLLO (PRESIDENT)
(314) 996-8401
Entity
Organization
Contact information
Practice address
1 CHILDRENS PL, LS 2, SAINT LOUIS, MO 63110-1002
(314) 454-6250
(314) 454-4006
Mailing address
PO BOX 504225, SAINT LOUIS, MO 63150-0001
(314) 454-6250
(314) 454-4006
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
324-2
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010930907
—
MO
Enumeration date
01/16/2007
Last updated
03/16/2021
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