Individual
NARUMOL CHONGTHANAVANIT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS,MS
Contact information
Practice address
3320 RUTGER ST, SAINT LOUIS, MO 63104-1122
(314) 977-8363
Mailing address
3320 RUTGER ST, SAINT LOUIS, MO 63104-1122
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
07/05/2012
Last updated
07/05/2012
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