Organization
LESTER C JOERN, JR, DDS, PC
Active
Other names
South St. Louis Dental Group
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LESTER C JOERN JR. DDS (PRESIDENT)
(314) 752-7468
Entity
Organization
Contact information
Practice address
6451 CHIPPEWA ST, SUITE A, SAINT LOUIS, MO 63109-2104
(314) 752-7468
(314) 752-5168
Mailing address
6451 CHIPPEWA ST, SUITE A, SAINT LOUIS, MO 63109-2104
(314) 752-7468
(314) 752-5168
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12510
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
014487
AETNA DMO
MO
01
—
103333
CIGNA DHMO
MO
01
—
15138
BCBS - MO
MO
01
—
519832
WITH UNITED CONCORDIA
MO
01
—
CBAR1
BCBS - ARKANSAS
MO
01
—
V12510
BCBS - TEXAS
MO
Enumeration date
10/03/2005
Last updated
08/22/2020
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