Individual
DR. MEGAN THERESE FASANELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
4590 S LINDBERGH BLVD, SAINT LOUIS, MO 63127-1832
(847) 922-6709
Mailing address
4590 S LINDBERGH BLVD, SAINT LOUIS, MO 63127-1832
(847) 922-6709
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2016016439
MO
Other
Enumeration date
05/24/2016
Last updated
05/24/2016
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