Individual
DR. ADAM DECOTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1391 SMIZER MILL RD, SUITE 104, FENTON, MO 63026-7306
(636) 349-2400
Mailing address
1391 SMIZEZ MILL RD, SUITE 104, FENTON, MO 63026
(636) 349-2400
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2000158415
MO
Other
Enumeration date
05/03/2007
Last updated
07/08/2007
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