Provider Demographics
NPI:1801902325
Name:FRENCH, ROBERT C (DMD, FICD, P)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:C
Last Name:FRENCH
Suffix:
Gender:M
Credentials:DMD, FICD, P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:121 BRYN WYCK PL
Mailing Address - Street 2:
Mailing Address - City:CREVE COEUR
Mailing Address - State:MO
Mailing Address - Zip Code:63141-8007
Mailing Address - Country:US
Mailing Address - Phone:314-878-7769
Mailing Address - Fax:314-432-1109
Practice Address - Street 1:777 S NEW BALLAS RD
Practice Address - Street 2:SUITE 213W
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-8705
Practice Address - Country:US
Practice Address - Phone:314-432-5470
Practice Address - Fax:314-432-1109
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0150681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO015068OtherLICENSE NUMBER
MO107391OtherBLUE CROSS/BLUE SHIELD
MO818249OtherUNITED CONCORDIA