Organization
MARK MANGELS, DMD, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK ALAN MANGELS DMD (OWNER)
(636) 970-0295
Entity
Organization
Contact information
Practice address
1 MID RIVERS MALL DR, SUITE 370, SAINT PETERS, MO 63376-4320
(636) 970-0295
Mailing address
1 MID RIVERS MALL DR, SUITE 370, SAINT PETERS, MO 63376-4320
(636) 970-0295
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
013969
MO
Other
Enumeration date
06/12/2007
Last updated
11/01/2007
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