Individual
MRS. JAMIE RANAE MANGELS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
709 JEFFERSON ST, WASHINGTON, MO 63090-2709
(636) 239-2316
(636) 239-3316
Mailing address
521 N CENTRAL AVE, SAINT LOUIS, MO 63130-3907
(618) 541-8968
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2006021038
MO
Other
Enumeration date
04/26/2007
Last updated
01/17/2017
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