Provider Demographics
NPI:1235351503
Name:ROW PUCEL LLC
Entity Type:Organization
Organization Name:ROW PUCEL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CURTIS
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:ROW
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:636-391-1911
Mailing Address - Street 1:510 BAXTER ROAD
Mailing Address - Street 2:STE 3
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-7032
Mailing Address - Country:US
Mailing Address - Phone:636-391-1911
Mailing Address - Fax:636-391-0629
Practice Address - Street 1:510 BAXTER ROAD
Practice Address - Street 2:STE 3
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-7032
Practice Address - Country:US
Practice Address - Phone:636-391-1911
Practice Address - Fax:636-391-0629
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2008-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO110581223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty