Individual
ISAAC CORONEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1500 PARK AVE, SAINT LOUIS, MO 63104-3024
(314) 814-8700
Mailing address
6018 ARTHUR AVE, SAINT LOUIS, MO 63139-1915
Taxonomy
Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
Primary
123
MO
Other
Enumeration date
06/15/2023
Last updated
06/15/2023
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