Organization
KEVIN D. BURGDORF DDS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEVIN D BURGDORF DDS (OWNER)
(314) 291-9000
Entity
Organization
Contact information
Practice address
12266 DEPAUL DRIVE, SUITE 325, BRIDGETON, MO 63044-2514
(314) 291-9000
(314) 291-0590
Mailing address
12266 DEPAUL DRIVE, SUITE 325, BRIDGETON, MO 63044-2514
(314) 291-9000
(314) 291-0590
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2009008266
MO
Other
Enumeration date
09/10/2015
Last updated
09/10/2015
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