Individual provider · Type 1 NPI

Somkamol Vanichvatana, DDS

Student in an Organized Health Care Education/Training Program · St. Louis, MO

NPI number 1548675176 Active

Practice location

3320 Rutger St
St. Louis, MO 63104-1122

Call (314) 977-8363 Map

Mailing address

18 S Kingshighway Blvd, Apt 9S
St. Louis, MO 63108-1356

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1548675176

Somkamol Vanichvatana, DDS's National Provider Identifier is 1548675176, issued on Jun 23, 2014. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in St. Louis, MO. The record was last updated on Jun 23, 2014.