Provider Demographics
NPI:1639112980
Name:VREELAND, DAVID L (DDS,MS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:L
Last Name:VREELAND
Suffix:
Gender:M
Credentials:DDS,MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14397 MANCHESTER RD
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:MO
Mailing Address - Zip Code:63011-4091
Mailing Address - Country:US
Mailing Address - Phone:636-256-0082
Mailing Address - Fax:314-754-9759
Practice Address - Street 1:14397 MANCHESTER RD
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:MO
Practice Address - Zip Code:63011-4091
Practice Address - Country:US
Practice Address - Phone:636-256-0082
Practice Address - Fax:314-754-9759
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0131641223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics