NPI 1164650883

Maryann L Udy, DMD

Practitioner Oral and Maxillofacial Surgery (Dentist) O'Fallon, MO

Practice location

Address: 5551 Winghaven Blvd., STE 210, O'Fallon, MO 63368
Phone: (636) 978-6967
Fax: (636) 978-5905

Registered specialties

Oral and Maxillofacial Surgery (Dentist) Primary

Dental Providers Taxonomy 1223S0112X Licence 2013009771 (MO)

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Registry record

NPI: 1164650883
Entity type: Individual
Sex (as registered): Female
NPI issued: 1 Jul 2009
Record last updated: 1 May 2020

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.