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Individual

DR. MICHAEL VINCENT PURCELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
923 MANSIONHILL DR, BALLWIN, MO 63011-2821
(636) 285-2648
Mailing address
PO BOX 537, CEDAR HILL, MO 63016-0537
(636) 285-2648

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
11808
MO

Other

Enumeration date
12/21/2011
Last updated
12/21/2011
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