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Organization

JESSICA C. NIEVA DDS P.C.

Active
Other names
Fenton Family Dentistry
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JESSICA C. NIEVA DDS (DENTIST/PRESIDENT)
(636) 326-7633
Entity
Organization

Contact information

Practice address
552 OLD SMIZER MILL RD, FENTON, MO 63026-3538
(636) 326-7633
Mailing address
552 OLD SMIZER MILL RD, FENTON, MO 63026-3538
(636) 326-7633

Taxonomy

Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
2002016551
MO

Other

Enumeration date
09/23/2008
Last updated
09/23/2008
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