Individual
DR. KEVIN RUSSELL DUNIVEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
11426 GRAVOIS RD, SUITE 202, SAINT LOUIS, MO 63126-3656
(314) 962-1574
(314) 962-8585
Mailing address
11426 GRAVOIS RD, SUITE 202, SAINT LOUIS, MO 63126-3656
(314) 962-1574
(314) 962-8585
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2012015445
MO
Other
Enumeration date
05/23/2012
Last updated
10/12/2015
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