Provider Demographics
NPI:1649700964
Name:BREE, ADAM J (DMD)
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:J
Last Name:BREE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 OLD BALLAS RD STE 118
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-7070
Mailing Address - Country:US
Mailing Address - Phone:314-993-5310
Mailing Address - Fax:314-993-5936
Practice Address - Street 1:605 OLD BALLAS RD STE 118
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-7070
Practice Address - Country:US
Practice Address - Phone:314-993-5310
Practice Address - Fax:314-993-5936
Is Sole Proprietor?:No
Enumeration Date:2017-06-19
Last Update Date:2017-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20170202731223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice