Individual
DR. MICHAEL BRIAN DIETRICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
3439 BRIDGELAND DR, BRIDGETON, MO 63044-2604
(314) 291-2777
(314) 291-9873
Mailing address
3439 BRIDGELAND DR, BRIDGETON, MO 63044-2604
(314) 291-2777
(314) 291-9873
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
14818
MO
Other
Enumeration date
08/31/2006
Last updated
07/08/2007
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