Organization
TYLER M AHOLT DDS LLC
Active
Other names
Lester C Joern Jr DDS PC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TYLER M AHOLT DDS (OWNER)
(314) 752-7468
Entity
Organization
Contact information
Practice address
6451 CHIPPEWA ST, SAINT LOUIS, MO 63109-2104
(314) 752-7468
(314) 752-5168
Mailing address
6451 CHIPPEWA ST, SAINT LOUIS, MO 63109-2104
(314) 752-7468
(314) 752-5168
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2012015662
MO
Other
Enumeration date
11/17/2015
Last updated
11/17/2015
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