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General NPI Number Information
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NPI Number | 1376038935
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Entity Type | Individual
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Provider Name | SABLE ANNE- MARIE MUNTEAN DMD, MHSA
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Gender | Female
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Dates
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Enumeration Date | 06/26/2018
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Last Update Date | 06/20/2024
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Provider Practice Location Address
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Address Line | 915 N GRAND BLVD
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City | SAINT LOUIS
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State | MO
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Zip | 63106-1621
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Country | US
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Telephone | 314-289-7675
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Fax |
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Provider Business Mailing Address
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Address Line | 9 VILLA CT APT B
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City | EDWARDSVILLE
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State | IL
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Zip | 62025-4425
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 019031770
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 23482
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 104916
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 2020023081
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License Number State | MO
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