Mandefro, Azaryas Tadiwos
Mandefro, Azaryas Tadiwos is an sole proprietor health care provider with primary practice located at 1708 Missouri State Rd , Arnold MO 63010-4603. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Mandefro, Azaryas Tadiwos can be contacted via phone (636) 287-9331.Contact Information
Primary practice address
1708 Missouri State Rd
Arnold MO 63010-4603
Phone: (636) 287-9331
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | 2009032198 | Missouri |
Profile Details
| NPI number | 1881922193 |
|---|---|
| LBN Legal business name | Mandefro, Azaryas Tadiwos |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 24th, 2009 |
| Last updated | Apr 21st, 2011 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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