Organization
DYNASTY DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELIZABETH J BURNS DDS (OWNER)
(314) 494-7967
Entity
Organization
Contact information
Practice address
810 OFALLON RD, STE 70, WELDON SPRING, MO 63304-8102
(636) 699-9815
Mailing address
810 OFALLON RD, ST E 70, WELDON SPRING, MO 63304-8102
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
15228
MO
Other
Enumeration date
09/24/2012
Last updated
09/24/2012
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