Organization
SOH OF MISSOURI
Active
Parent organization
SOH OF MISSOURI SAMSON LIU PC
Other names
Weldon Spring Dental
Organization subpart
Yes
Provider details
NPI number
Legal business name
SOH OF MISSOURI SAMSON LIU PC
Authorized official
ASHLY SUNSHINE (CREDENTIALING SPECIALIST)
(314) 413-2803
Entity
Organization
Contact information
Practice address
810 OFALLON RD # I, WELDON SPRING, MO 63304-8102
(314) 753-8154
Mailing address
810 OFALLON RD # I, WELDON SPRING, MO 63304-8102
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2000164557
MO
1223G0001X
General Practice Dentistry
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Enumeration date
03/01/2018
Last updated
06/16/2026
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