Organization
MID-AMERICA DENTAL SLEEP MEDICINE LLC
Active
Organization
MID-AMERICA DENTAL SLEEP MEDICINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEVIN C WALDE DDS MS (OWNER)
(636) 239-5151
Entity
Organization
Contact information
Practice address
1507 HERITAGE HILLS DR, WASHINGTON, MO 63090-4614
(636) 239-5151
(636) 390-2728
Mailing address
1507 HERITAGE HILLS DR, WASHINGTON, MO 63090-4614
(636) 239-5151
(636) 390-2728
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
013936
MO
Other
Enumeration date
06/10/2014
Last updated
06/10/2014
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