Provider Demographics
NPI:1376958777
Name:LOCOCO, LINDSAY (DDS)
Entity Type:Individual
Prefix:DR
First Name:LINDSAY
Middle Name:
Last Name:LOCOCO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 HAMPTON VILLAGE PLZ
Mailing Address - Street 2:SUITE 212
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63109-2128
Mailing Address - Country:US
Mailing Address - Phone:314-481-7656
Mailing Address - Fax:
Practice Address - Street 1:16 HAMPTON VILLAGE PLZ
Practice Address - Street 2:SUITE 212
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63109-2128
Practice Address - Country:US
Practice Address - Phone:314-481-7656
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-24
Last Update Date:2014-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20140168181223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice