Organization
NEW CREATION CENTER FOR DENTAL SLEEP MEDICINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW BOSCIA D.M.D (DENTIST)
(636) 625-1225
Entity
Organization
Contact information
Practice address
15 LAKESIDE DR STE A, LAKE ST LOUIS, MO 63367-1378
(636) 625-1225
(636) 625-1228
Mailing address
15 LAKESIDE DR STE A, LAKE ST LOUIS, MO 63367-1378
(636) 625-1225
(636) 625-1228
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2003013106
MO
Other
Enumeration date
02/26/2016
Last updated
07/22/2016
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