Individual
DR. MARK ALAN MANGELS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1 MID RIVERS MALL DR, SUITE 370, SAINT PETERS, MO 63376-4320
(636) 970-0295
(636) 278-3033
Mailing address
521 N CENTRAL AVE, SAINT LOUIS, MO 63130-3907
(618) 593-1438
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
2005013969
MO
Other
Enumeration date
08/03/2006
Last updated
01/04/2017
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