Charles E. Niesen II, DMD, Michael J. Faddis, DDS
Charles E. Niesen II, DMD, Michael J. Faddis, DDS is a 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
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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