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NPI Code Detail

MEDICARE: SONU MUTHUVALLIAPPAN DMD

MEDICARE:   SONU  MUTHUVALLIAPPAN  DMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist2008015950MO

General Provider Information

NPI Number : 1730345455
Entity Type Code : Individual
Provider Name (Legal Business Name) : SONU MUTHUVALLIAPPAN DMD
Provider Business Mailing Address
First Line : 1338 SUNBURST DR
Second Line :
City : O FALLON
State : MO
Zip : 63366-3491
Country : US
Telephone Number : 636-272-3503
Fax Number :
Provider Business Practice Location Address
First Line : 1338 SUNBURST DR
Second Line :
City : O FALLON
State : MO
Zip : 63366-3491
Country : US
Telephone Number : 636-272-3503
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/01/2008
Last Update Date : 08/01/2008

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Directions to “ SONU MUTHUVALLIAPPAN DMD” Practice Location

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