Individual
MARK ELIOT OSBORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1717 BIDDLE ST, SAINT LOUIS, MO 63106-3454
(314) 814-8515
(314) 814-8542
Mailing address
360 WEST POINT COURT, ST LOUIS, MO 63130
(314) 727-5963
(314) 814-8542
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
012730
MO
Other
Enumeration date
01/24/2007
Last updated
03/27/2013
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