Individual
ELISA MULKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
627 S TRUMAN BLVD, FESTUS, MO 63028-2234
(636) 777-4679
Mailing address
1002 N TAYLOR AVE, CRYSTAL CITY, MO 63019-1210
(314) 602-0862
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2025024087
MO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/10/2025
Last updated
06/23/2025
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