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Individual

DR. FAYE LICATA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DMD FAGD PC

Contact information

Practice address
111 HILLTOWN VILLAGE CTR STE 200, CHESTERFIELD, MO 63017-1712
(636) 532-2101
(636) 532-2209
Mailing address
111 HILLTOWN VILLAGE CTR STE 200, CHESTERFIELD, MO 63017-1712
(636) 532-2101
(636) 532-2209

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
015059
MO

Other

Enumeration date
07/22/2013
Last updated
07/22/2013
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