Individual
DAVID M IVEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
11710 OLD BALLAS RD STE 205, SAINT LOUIS, MO 63141-7076
(314) 866-6725
(314) 998-6725
Mailing address
10200 W MAIN ST, BELLEVILLE, IL 62223-1408
(618) 400-6725
(618) 500-6725
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
012332
MO
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
12332
MO
Other
Enumeration date
10/17/2006
Last updated
02/29/2024
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