St. Louis Surgical Associates, LLC
NPI #1093064057 in Glen Carbon, Illinois
Provider Information
- NPI Number
- 1093064057
- Entity Type
- Organization
- Organization Name
- St. Louis Surgical Associates, LLC
- Primary Specialty
- Dentist - Periodontics
- Enumeration Date
- Sep 6, 2012
- Last Updated
- Nov 30, 2015
Practice Location
- Address
- 24 GINGER CREEK PKWY
- City
- Glen Carbon
- State
- Illinois
- ZIP Code
- 62034-3502
- Phone
- (618) 655-1580
Authorized Official
- Name
- DAVID GUILBEAULT, DMD
- Title
- OWNER
- Phone
- (618) 643-9523
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - Periodontics — Periodontics |
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