Provider Demographics
NPI:1598077927
Name:KRISTIANE NAEGLER DMD, LLC
Entity Type:Organization
Organization Name:KRISTIANE NAEGLER DMD, LLC
Other - Org Name:ACCENT DENTAL OF ST. LOUIS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KRISTIANE
Authorized Official - Middle Name:M
Authorized Official - Last Name:NAEGLER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:314-862-2006
Mailing Address - Street 1:1405 S HANLEY RD STE 100
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63144-2902
Mailing Address - Country:US
Mailing Address - Phone:314-862-2006
Mailing Address - Fax:314-862-2003
Practice Address - Street 1:1405 S HANLEY RD STE 100
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63144-2902
Practice Address - Country:US
Practice Address - Phone:314-862-2006
Practice Address - Fax:314-862-2003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-14
Last Update Date:2018-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0158141223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty