Organization
KEVIN M. KILLIAN, D.D.S.,P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEVIN M. KILLIAN D.D.S. (PRESIDENT)
(636) 970-2699
Entity
Organization
Contact information
Practice address
625 SALT LICK RD, SAINT PETERS, MO 63376-1170
(636) 970-2699
Mailing address
625 SALT LICK RD, SAINT PETERS, MO 63376-1170
(636) 970-2699
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
14633
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1225148273
DOCTOR
MO
Enumeration date
01/04/2008
Last updated
01/04/2008
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