Provider Demographics
NPI:1811070469
Name:WM. GERALD ALBRECHT, DDS PC
Entity type:Organization
Organization Name:WM. GERALD ALBRECHT, DDS PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:GERALD
Authorized Official - Last Name:ALBRECHT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS PC
Authorized Official - Phone:314-822-2764
Mailing Address - Street 1:3555 SUNSET OFFICE DR
Mailing Address - Street 2:SUITE 210
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63127-1015
Mailing Address - Country:US
Mailing Address - Phone:314-822-2764
Mailing Address - Fax:314-822-5758
Practice Address - Street 1:3555 SUNSET OFFICE DR
Practice Address - Street 2:SUITE 210
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63127-1015
Practice Address - Country:US
Practice Address - Phone:314-822-2764
Practice Address - Fax:314-822-5758
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-24
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty