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Organization

FAYE E LICATA DMD FAGD PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. FAYE E LICATA DMD (DENTIST OWNER)
(636) 532-2101
Entity
Organization

Contact information

Practice address
111 HILLTOWN VILLAGE CENTER, SUITE #200, CHESTERFIELD, MO 63017
(636) 532-2101
(636) 532-2209
Mailing address
111 HILLTOWN VILLAGE CENTER, SUITE #200, CHESTERFIELD, MO 63017
(636) 532-2101
(636) 532-2209

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
015059
MO

Other

Enumeration date
10/27/2006
Last updated
07/22/2013
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