Organization
DECO DENTAL
Active
Organization
DECO DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ADAM DECOTA (DENTIST)
(636) 349-2400
Entity
Organization
Contact information
Practice address
1391 SMIZER MILL RD, FENTON, MO 63026-7306
(636) 349-2400
Mailing address
1391 SMIZER MILL RD, FENTON, MO 63026-7306
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
1807416-2
MO
Other
Enumeration date
05/21/2007
Last updated
08/22/2020
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