NPI 1003920174

Michael Edlin, DMD

Practitioner General Practice Dentistry Saint Louis, MO

Practice location

Address: 8000 Bonhomme Ave Suite 306, Saint Louis, MO 63105-3515
Phone: (314) 863-2222
Fax: (314) 863-5225
Mailing address: 8000 Bonhomme Ave. Suite 306, St. Louis, MO 63105

Registered specialties

General Practice Dentistry Primary

Dental Providers Taxonomy 1223G0001X Licence 14966 (MO)

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Registry record

NPI: 1003920174
Entity type: Individual
Sex (as registered): Male
NPI issued: 18 Aug 2006
Record last updated: 8 Jul 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.