Individual
JAN SUSAN OLIVIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
2821 N BALLAS RD STE 140, SAINT LOUIS, MO 63131-2377
(314) 432-5544
Mailing address
2821 N BALLAS RD STE 140, SAINT LOUIS, MO 63131-2377
(314) 432-5544
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1999139477
MO
Other
Enumeration date
11/17/2006
Last updated
07/21/2022
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