Individual
JULIA JANE ANN VIDYAKIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
408 S BROADVIEW ST, CAPE GIRARDEAU, MO 63703-5725
(573) 332-0808
Mailing address
408 S BROADVIEW ST, CAPE GIRARDEAU, MO 63703-5725
(573) 332-0808
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2022020735
MO
Other
Enumeration date
06/09/2022
Last updated
10/23/2024
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