Organization
SHAW PARK DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIPALI THAKKER (MANAGING MEMBER)
(618) 558-2510
Entity
Organization
Contact information
Practice address
225 S MERAMEC AVE STE 311, SAINT LOUIS, MO 63105-3511
(314) 727-2420
Mailing address
501 EISENHOWER BLVD, TROY, IL 62294-3341
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
06/08/2026
Last updated
06/08/2026
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