Individual
KENDRA PHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
19515 BRUNE PKWY, WARRENTON, MO 63383-6505
(844) 853-8937
Mailing address
1500 PARK AVE, SAINT LOUIS, MO 63104-3024
(314) 881-8254
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2025018921
MO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/12/2023
Last updated
05/29/2025
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