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Individual

DR. STEPHEN DOMINICK VITALE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
6651 CHIPPEWA ST, SUITE 100, ST LOUIS, MO 63109-2530
(314) 647-2424
(314) 647-2466
Mailing address
6651 CHIPPEWA, STE 100, ST LOUIS, MO 63109-2530
(314) 647-2424
(314) 647-2466

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12555
MO

Other

Enumeration date
09/28/2006
Last updated
07/08/2007
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