Individual
MEGHAN KOENNECKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
15817 FOUNTAIN PLAZA DR, CHESTERFIELD, MO 63017-7468
(636) 220-1104
Mailing address
11721 OLD BALLAS RD APT 308, CREVE COEUR, MO 63141-3404
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2021013965
MO
Other
Enumeration date
05/17/2021
Last updated
05/17/2021
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