IndividualActive
Isaac Coronel
NPI 1609550912 · Public Health Dentistry · Saint Louis, MO
Provider details
- NPI number
- 1609550912
- Entity type
- Individual
- Primary specialty
- Public Health DentistryDental Providers
- Sex
- Male
- Sole proprietor
- Yes
- License
- 123 (MO)
Specialties & taxonomies
Dental Providers
Practice location
1500 Park Ave
Saint Louis, MO 63104-3024
Phone: (314) 814-8700
Approximate (ZIP-level) locationGet directions
Mailing address
6018 Arthur Ave
Saint Louis, MO 63139-1915
Registry dates
- Enumerated
- 2023-06-15
- Last updated
- 2023-06-15
- Certified
- 2023-06-15
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.