Individual
MICHELLE SHANTA PAIGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
750 GRAVOIS BLUFFS BLVD STE C, FENTON, MO 63026-7720
(636) 203-4100
(636) 203-4105
Mailing address
750 GRAVOIS BLUFFS BLVD STE C, FENTON, MO 63026-7720
(636) 203-4100
(636) 203-4105
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2020013899
MO
Other
Enumeration date
05/28/2020
Last updated
09/01/2022
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