Individual
DR. HARRY JEROME FONDREN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
7645 DELMAR BLVD, SAINT LOUIS, MO 63130-3910
(314) 727-6323
(314) 727-9263
Mailing address
7645 DELMAR BLVD., SAINT LOUIS, MO 63130
(314) 727-6323
(314) 727-9263
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12216
MO
Other
Enumeration date
06/06/2007
Last updated
07/08/2007
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