Provider Demographics
NPI:1316020308
Name:STUART D. WAITE DDS PC
Entity Type:Organization
Organization Name:STUART D. WAITE DDS PC
Other - Org Name:DR. WAITE & ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STUART
Authorized Official - Middle Name:D
Authorized Official - Last Name:WAITE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:314-251-5775
Mailing Address - Street 1:621 S NEW BALLAS RD
Mailing Address - Street 2:SUITE 10A
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-8232
Mailing Address - Country:US
Mailing Address - Phone:314-251-5775
Mailing Address - Fax:314-251-5776
Practice Address - Street 1:621 S NEW BALLAS RD
Practice Address - Street 2:SUITE 10A
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-8232
Practice Address - Country:US
Practice Address - Phone:314-251-5775
Practice Address - Fax:314-251-5776
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty