Individual
KEITH ANDREW NIKODEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4420 LEMAY FERRY RD, SAINT LOUIS, MO 63129-1758
(314) 487-1515
(314) 416-8322
Mailing address
4420 LEMAY FERRY RD, SAINT LOUIS, MO 63129-1758
(314) 487-1515
(314) 416-8322
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2001024027
MO
Other
Enumeration date
02/27/2007
Last updated
07/08/2007
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