Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Creve Coeur Periodontics, Inc

Organization Periodontics · NPI 1174799415

Creve Coeur Periodontics, Inc is a Periodontics in Creve Coeur, Missouri. Licensed in Missouri. Registered with an NPI since 2008.

Licensed in
MO
In the registry since
2008
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

11709 Old Ballas Rd Ste 206
Creve Coeur, MO 63141-7029
Phone: (314) 567-3760
Fax: (314) 567-3929
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Periodontics (primary) Taxonomy 1223P0300X · Licence 14247 (MO)

Record details

NPI number1174799415
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Marwan Assaf — Owner · (314) 567-3760
NPI enumeratedMay 6, 2008
Last updated in NPPESMay 6, 2008
Mailing address11709 Old Ballas Rd, Suite 206, Creve Coeur, MO 63141-7029

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