Charles E. Niesen II, DMD, Michael J. Faddis, DDS
Charles E. Niesen II, DMD, Michael J. Faddis, DDS provides General Practice Dentistry in Saint Louis, Missouri. Registered with an NPI since 2006.
- In the registry since
- 2006
Practice location Address checks out
2440 S Brentwood BlvdSaint Louis, MO 63144-2321 Not confirmed with CMS for 19 years — call before visiting
Phone: (314) 962-6643
Fax: (314) 962-2205
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| General Practice Dentistry (primary) | Taxonomy 1223G0001X |
|---|
Record details
| NPI number | 1548321318 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Michael Faddis — Owner · (314) 962-6643 |
| Other names | Brentwood Dental Group |
| NPI enumerated | December 13, 2006 |
| Last updated in NPPES | August 21, 2007 |
| Mailing address | 2440 S Brentwood Blvd, Saint Louis, MO 63144-2321 |
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