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Organization

SPIRIT DENTAL, LLC

Active
Other names
Jack E. Wolf D.M.D.
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JACK E. WOLF D.M.D. (OWNER)
(636) 530-7260
Entity
Organization

Contact information

Practice address
109 LONG RD, CHESTERFIELD, MO 63005
(636) 530-7260
(636) 733-9084
Mailing address
109 LONG RD, CHESTERFIELD, MO 63005
(636) 530-7260
(636) 733-9084

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
014616
MO

Other

Enumeration date
06/18/2007
Last updated
08/25/2009
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