Organization
PEDAITRIC DENTAL AND ORTHODONTIC ASSOCIATES OF ST LOUIS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS VERALDI D.M.D. (OWNER)
(314) 965-7630
Entity
Organization
Contact information
Practice address
430 S CLAY AVE, KIRKWOOD, MO 63122-5808
(314) 965-7630
Mailing address
430 S CLAY AVE, KIRKWOOD, MO 63122-5808
(314) 965-7630
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
14227
MO
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
14227
MO
Other
Enumeration date
01/19/2011
Last updated
01/19/2011
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