OrganizationActive
Smile Brilliant Ventures
NPI 1023836673 · Dental Laboratory · Fenton, MO
Provider details
- NPI number
- 1023836673
- Entity type
- Organization
- Primary specialty
- Dental LaboratoryLaboratories
- Organization subpart
- No
- Authorized official
- Michael Bluestone, Business Owner(314) 409-3598
Specialties & taxonomies
Laboratories
Practice location
1645 Headland Dr
Fenton, MO 63026-2836
Phone: (855) 944-8361
Approximate (ZIP-level) locationGet directions
Mailing address
1645 Headland Dr
Fenton, MO 63026-2836
Registry dates
- Enumerated
- 2024-10-02
- Last updated
- 2024-10-02
- Certified
- 2024-10-02
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.