Individual
MS. STEPHANIE GAIL RIEVENUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
189 BAKER AVE, WEBSTER GROVE, MO 63119
(314) 961-1160
(314) 961-7822
Mailing address
2300 SOUTH 10TH, #F, ST LOUIS, MO 63104
(618) 713-7233
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
2003013288
MO
Other
Enumeration date
03/22/2007
Last updated
07/08/2007
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