Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2082S0105X | Plastic Hand Surgeon | 2018021870 | MO |
NPI | 1205312741 |
---|---|
Provider Name | Jana Dengler |
First Address | Saint Louis, MO 63110 |
Second Address | Saint Louis, MO 63110-1003 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2018 |
Last Update Date | 18/07/2018 |