Organization
MISSOURI CENTER FOR ORAL SURGERY AND IMPLANTS LLC
Active
Parent organization
KENNETH CLARK PRIDDY, DDS, MD, PC
Other names
Oral and Maxillofacial Surgery at the Crossing, Kelsey Smith, DDS, MD, PC, First Capitol Oral and Maxillofacial Surgery
Organization subpart
Yes
Provider details
NPI number
Legal business name
KENNETH CLARK PRIDDY, DDS, MD, PC
Authorized official
DR. KELSEY CAITLIN SMITH DDS, MD (PARTNER)
(314) 956-5651
Entity
Organization
Contact information
Practice address
853 MEDICAL DR STE 115, WENTZVILLE, MO 63385-3825
(636) 887-3100
(636) 887-3102
Mailing address
1 MID RIVERS MALL DR STE 310, SAINT PETERS, MO 63376-4323
(636) 928-7217
(636) 397-0223
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
12/15/2022
Last updated
03/27/2023
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