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Individual

DR. MICHAEL P GENOVESE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
6065 MID RIVERS MALL DR, COTTLEVILLE, MO 63304
(636) 928-4090
(639) 928-4555
Mailing address
6065 MID RIVERS MALL DRIVE, COTTLEVILLE, MO 63304
(636) 928-4090
(636) 928-4555

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
14125
MO

Other

Enumeration date
12/04/2006
Last updated
07/08/2007
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