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1245340025
ELLIS BASIL MEMOS
ST LOUIS, MO
NPI
1245340025
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: MO 9757)
Enumeration Date
2006-08-30
Last Update Date
2007-07-08
Business Address
Dr. ELLIS BASIL MEMOS DDS
5108 HAMPTON AVE
ST LOUIS, MO 63109-3113
Phone number: 314-832-4816
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Mailing Address
Dr. ELLIS BASIL MEMOS DDS
5108 HAMPTON AVE
ST LOUIS, MO 63109-3113
Phone number: 314-832-4816
Copy
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