Organization
NEW CREATION DENTAL CARE LC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW BOSCIA D.M.D. (PRESIDENT)
(636) 625-1225
Entity
Organization
Contact information
Practice address
15 LAKESIDE DR STE A, LAKE ST LOUIS, MO 63367-1378
(636) 625-1225
Mailing address
15 LAKESIDE DR STE A, LAKE ST LOUIS, MO 63367-1378
(636) 625-1225
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2003013106
MO
Other
Enumeration date
04/12/2007
Last updated
01/16/2026
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