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Individual

DR. CORY CHARLES CAMPANELLA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
589 MID RIVERS MALL DR, SAINT PETERS, MO 63376-2152
(636) 970-1595
Mailing address
5204 WINGHAVEN POINTE DR, O FALLON, MO 63368-7646

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019032147
IL

Other

Enumeration date
06/05/2019
Last updated
06/05/2019
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