ELLIS BASIL MEMOS

ST LOUIS, MO
NPI1245340025
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1223G0001X Dentist, General Practice
(Licence: MO  9757)
Enumeration Date2006-08-30
Last Update Date2007-07-08
Business Address
Dr. ELLIS BASIL MEMOS DDS
5108 HAMPTON AVE
ST LOUIS, MO 63109-3113
Phone number: 314-832-4816
Mailing Address
Dr. ELLIS BASIL MEMOS DDS
5108 HAMPTON AVE
ST LOUIS, MO 63109-3113
Phone number: 314-832-4816