Organization
ST.LOUIS CENTER FOR AESTHETIC AND RESTOR. DENTISTRY/LINDBERGH SMILE
Active
Parent organization
SOH OF MISSOURI SAMSON LIU PC
Organization subpart
Yes
Provider details
NPI number
Legal business name
SOH OF MISSOURI SAMSON LIU PC
Authorized official
RAY WEBER (SUPPORT SPECIALIST)
(314) 753-8154
Entity
Organization
Contact information
Practice address
7934 N LINDBERGH BLVD, HAZELWOOD, MO 63042-3521
(314) 831-8086
Mailing address
1422 ELBRIDGE PAYNE RD STE 240, CHESTERFIELD, MO 63017-8544
(314) 753-8154
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
10/29/2018
Last updated
10/29/2018
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