Provider Demographics
NPI:1417917881
Name:MUETH, DANIEL J (DDS)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:J
Last Name:MUETH
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12818 TESSON FERRY RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63128-2945
Mailing Address - Country:US
Mailing Address - Phone:314-729-0489
Mailing Address - Fax:314-729-7235
Practice Address - Street 1:12818 TESSON FERRY RD
Practice Address - Street 2:SUITE 102
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63128-2945
Practice Address - Country:US
Practice Address - Phone:314-729-0489
Practice Address - Fax:314-729-7235
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MODE0153511223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice