Provider Demographics
NPI:1497978282
Name:GELCHION, RAYMOND W (DDS)
Entity Type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:W
Last Name:GELCHION
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 1:1536 YARMOUTH POINT DR
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-5640
Mailing Address - Country:US
Mailing Address - Phone:636-532-3988
Mailing Address - Fax:
Practice Address - Street 1:2300 SOUTH HIGHWAY 94
Practice Address - Street 2:
Practice Address - City:ST. CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63303-5622
Practice Address - Country:US
Practice Address - Phone:636-928-8400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO012469122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist