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General NPI Number Information
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NPI Number | 1598280455
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Entity Type | Individual
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Provider Name | DENNIS PEZZANI
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Gender | Male
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Dates
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Enumeration Date | 08/11/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1 ACADEMY PL
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City | DARDENNE PRAIRIE
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State | MO
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Zip | 63368-7602
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Country | US
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Telephone | 636-394-4270
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Fax |
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Provider Business Mailing Address
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Address Line | 637 OAK PATH DR
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City | BALLWIN
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State | MO
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Zip | 63011-3441
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Country | US
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Telephone | 636-394-4270
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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 | 1835P2201X
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Taxonomy Name | Ambulatory Care Pharmacist
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License Number | 027825
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License Number State | MO
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