Individual
CASEY N NIEKAMP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1849 WENTZVILLE PKWY, WENTZVILLE, MO 63385-3896
(636) 639-1720
(636) 639-1935
Mailing address
1849 WENTZVILLE PKWY, WENTZVILLE, MO 63385-3896
(636) 639-1720
(636) 639-1935
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2017019261
MO
Other
Enumeration date
06/14/2017
Last updated
07/21/2022
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