16111 Manchester Road, L.l.c.
NPI #1013386598 in Ellisville, Missouri
Provider Information
- NPI Number
- 1013386598
- Entity Type
- Organization
- Organization Name
- 16111 Manchester Road, L.l.c.
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Sep 15, 2015
- Last Updated
- Sep 15, 2015
Practice Location
- Address
- 428 OLD STATE RD.
- City
- Ellisville
- State
- Missouri
- ZIP Code
- 63021
- Phone
- (636) 391-6030
Authorized Official
- Name
- MR. CHARLES M. ZIEBA, DMD
- Title
- DENTIST/OWNER
- Phone
- (636) 391-6030
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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