Individual
DR. DENNIS T VILLAREAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4488 FOREST PARK AVE, STE 201, SAINT LOUIS, MO 63108-2215
(314) 286-2715
(314) 286-2701
Mailing address
660 S EUCLID AVE, C B 8031, SAINT LOUIS, MO 63110-1010
(314) 286-2715
(314) 286-2701
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
102107
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
208688002
—
MO
Enumeration date
07/14/2006
Last updated
01/28/2009
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