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Individual

EMMETT M BENTLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
2345 DOUGHERTY FERRY RD, SAINT LOUIS, MO 63122-3313
(314) 966-9590
Mailing address
800 SAINT PAUL RD, WILDWOOD, MO 63021-6011

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
DOR9613
MO

Other

Enumeration date
11/13/2006
Last updated
07/08/2007
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