Individual
VICTORIA LYNN DENTAMARO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10010 KENNERLY RD, SAINT LOUIS, MO 63128-2106
(314) 525-1911
Mailing address
1344 FIELDSTONE, WATERLOO, IL 62298-2780
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
041370086
IL
163W00000X
Registered Nurse
2008021302
MO
Other
Enumeration date
11/07/2017
Last updated
11/07/2017
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