Individual
MICHAEL F. CISSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1296 N HENKE RD, LAKE ST LOUIS, MO 63367-2121
(636) 561-1242
Mailing address
1296 N HENKE RD, LAKE ST LOUIS, MO 63367-2121
(636) 561-1242
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
011938
MO
Other
Enumeration date
10/20/2011
Last updated
10/20/2011
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