Organization
NIKODEM DENTAL CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES DANIEL HURLEY DDS (DENTIST)
(314) 731-7555
Entity
Organization
Contact information
Practice address
811 HAZELWEST DR, HAZELWOOD, MO 63042-1749
(314) 731-7555
(314) 731-7562
Mailing address
811 HAZELWEST DR, HAZELWOOD, MO 63042-1749
(314) 731-7555
(314) 731-7562
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
2014015546
MO
Other
Enumeration date
09/16/2014
Last updated
09/16/2014
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