Martin Kevin Eresh, DDS
Individual provider Active NPI General Practice Dentistry · High Ridge, MO
NPI 1326320672 · NPPES record last updated Sep 13, 2011
Key facts
- NPI
- 1326320672
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 12698 (MO)
- Practice address
- 1412-A Old Gravois Rd
High Ridge, MO 63049 - Phone
- (636) 343-8990
- NPI assigned
- Sep 13, 2011
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12698 | MO | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 12698 | MO | Yes |
Addresses
Primary practice location
1412-A Old Gravois Rd
High Ridge, MO 63049
Mailing address
1412-A Old Gravois Rd
High Ridge, MO 63049
Phone (636) 343-8990
Other providers in High Ridge, MO
- Julie Duncan
- Kristen Effan
- Amanda Ehlers
- Samuel Cooper Engemann
- Equinox Adult Day Care
- Faithful Hands Home Care LLC
- Joshua Stephen Faller
- Elizabeth Fernandez
- Kaitlyn Claire Finger
- First for You, P,C,
All providers in High Ridge, MO · General Practice Dentistry in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 13, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.