Dr. William L Mastorakos
Orthodontists
10115 Manchester Rd Ste 200
St Louis
, Missouri 63122
Dr. William L Mastorakos
Orthodontists
10115 Manchester Rd Ste 200
St Louis
, Missouri 63122
(314) 966-8630
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About
Features
Specialties
- Orthodontists
Languages spoken
- English
Location
First Address
- Dr. William L Mastorakos
- 10115 Manchester Rd Ste 200
- St Louis, MO
- Zip : 63122
- Fax : (314) 966-8630
- Phone : (314) 966-4117
Second Address
- Dr. William L Mastorakos
- 10115 Manchester Rd Ste 200
- St Louis, MO
- Zip : 63122
- Fax : (314) 966-8630
- Phone : (314) 966-4117
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223X0400X | Orthodontists | 013600 | MO |
National Provider Identifier
| NPI | 1063527604 |
|---|---|
| Provider Name | Dr. William L Mastorakos |
| First Address | St Louis, MO 63122 |
| Second Address | St Louis, MO 63122 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 21/08/2006 |
| Last Update Date | 08/07/2007 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.