Organization
LA CROSS DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID GUILBEAULT DMD (OWNER)
(618) 692-1110
Entity
Organization
Contact information
Practice address
11634 W FLORISSANT AVE, FLORISSANT, MO 63033-6723
(314) 322-4719
(314) 837-9778
Mailing address
11634 W FLORISSANT AVE, FLORISSANT, MO 63033-6723
(314) 322-4719
(314) 837-9778
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2013030663
MO
Other
Enumeration date
09/10/2014
Last updated
09/10/2014
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