Advanced Dentistry of O'fallon LLC

NPI #1750176103 in O Fallon, Missouri

Provider Information

NPI Number: 1750176103
Entity Type: Organization
Organization Name: Advanced Dentistry of O'fallon LLC
Primary Specialty: Dentist - General Practice
Enumeration Date: Apr 14, 2025
Last Updated: Apr 14, 2025

Practice Location

Address: 2990 HIGHWAY K
City: O Fallon
State: Missouri
ZIP Code: 63368-7861
Phone: (636) 978-7816

Authorized Official

Name: STACEY BARNES
Title: PRACTICE MANAGER
Phone: (636) 978-7816

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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