Individual
DR. JAMES EDWARD VANDEWATER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
164 CLARKSON EXECUTIVE PARK, ELLISVILLE, MO 63011
(636) 394-7330
(363) 394-7908
Mailing address
164 CLARKSON EXECUTIVE PARK, ELLISVILLE, MO 63011-2114
(636) 394-7330
(636) 394-7908
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
015342
MO
122300000X
Dentist
019020310
IL
Other
Enumeration date
08/22/2006
Last updated
02/23/2016
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