Organization
DIANE E VASQUEZ DDS LLC
Active
Other names
Olive Family Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DIANE ELIZABETH VASQUEZ DDS (GENERAL DENTIST)
(213) 915-1661
Entity
Organization
Contact information
Practice address
2690 GRAVOIS RD, HIGH RIDGE, MO 63049-2508
(636) 692-5803
Mailing address
1635 CLAYTON SPUR CT, ELLISVILLE, MO 63011-2012
(213) 915-1661
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
261QD0000X
Dental Clinic/Center
2018002617
MO
Other
Enumeration date
03/20/2018
Last updated
01/04/2022
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