Individual
ELENA GEORGIEVA IGNATOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S
Contact information
Practice address
5471 DR MARTIN LUTHER KING DR, SAINT LOUIS, MO 63112-4265
(314) 367-5820
(314) 367-6326
Mailing address
5471 DR MARTIN LUTHER KING DR, SAINT LOUIS, MO 63112-4265
(314) 367-5820
(314) 367-6326
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2011015329
MO
1223G0001X
General Practice Dentistry
019.028859
IL
Other
Enumeration date
09/28/2011
Last updated
08/27/2012
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