Individual
THOMAS MILTON RUNCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
64 CRESTWOOD EXECUTIVE CTR, SAINT LOUIS, MO 63126-1904
(314) 843-0470
(314) 843-0438
Mailing address
64 CRESTWOOD EXECUTIVE CTR, SAINT LOUIS, MO 63126-1904
(314) 843-0470
(314) 843-0438
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2014030147
MO
Other
Enumeration date
08/26/2014
Last updated
08/26/2014
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