NPI 1952469157

Michael P Genovese, DDS

Practitioner Dentist Cottleville, MO

Practice location

Address: 6065 Mid Rivers Mall Dr, Cottleville, MO 63304
Phone: (636) 928-4090
Fax: (639) 928-4555
Mailing address: 6065 Mid Rivers Mall Drive, Cottleville, MO 63304

Registered specialties

Dentist Primary

Dental Providers Taxonomy 122300000X Licence 14125 (MO)

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Registry record

NPI: 1952469157
Entity type: Individual
Sex (as registered): Male
NPI issued: 4 Dec 2006
Record last updated: 8 Jul 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.