Individual
GERUSA MELLO-ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
4945 STONE FALLS CTR, SUITE B, O FALLON, IL 62269-7802
(618) 622-0212
(618) 622-1996
Mailing address
4945 STONE FALLS CTR, SUITE B, O FALLON, IL 62269-7802
(618) 622-0212
(618) 622-1996
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
IL
Other
Enumeration date
10/05/2006
Last updated
07/08/2007
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