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16111 Manchester Road, L.l.c.
General Practice Dentistry in Ellisville, Missouri
NPI 1013386598

16111 Manchester Road, L.l.c. is a General Practice Dentistry based in Ellisville, MO and is specialized in General Practice. 16111 Manchester Road, L.l.c. practices in Ellisville, MO. The NPI Number for 16111 Manchester Road, L.l.c. is 1013386598 and holds a License No. 2000169958 (Missouri).

The current practice location address for 16111 Manchester Road, L.l.c. is 428 Old State Rd., Ellisville, MO and can be reached out via phone at 636-391-6030 and via fax at 636-527-8386.

Location: 428 Old State Rd., Ellisville, MO, 63021
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1013386598
Provider Name
16111 Manchester Road, L.l.c.
Credential
Provider Entity Type
Organization
Address
428 Old State Rd., Ellisville, MO, 63021
Phone Number
636-391-6030
Fax Number
636-527-8386
Provider Enumeration Date
09/15/2015
Last Update Date
03/13/2024
institution
Provider Business Practice Location Address Details
Address
428 Old State Rd.
City
Ellisville
State
Missouri
Zip
63021
Phone Number
636-391-6030
Fax Number
636-527-8386
person
Provider Business Mailing Address Details
Address
428 Old State Rd.
City
Ellisville
State
Missouri
Zip
63021
Phone Number
636-391-6030
Fax Number
636-527-8386
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
General Practice
Taxonomy
1223G0001X
License No.
2000169958 (Missouri)
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
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