Female

Autumn R. Vangennip RDH

Dental Hygienist in Cape Girardeau, MO(View on Map)

Full Name

Autumn Rose Vangennip RDH

NPI Number

1609295674

NPI Type

Individual Provider

Gender

Female

Enumeration Date

04/07/2014

Specialties

(Taxonomies)

Code

124Q00000X

Primary Taxonomy

Yes

Licenses

State

Missouri

License Number

2011017963

Contact
Information

Purpose

Mailing
Location

Address

408 S BROADVIEW ST
408 S BROADVIEW ST

City

Cape Girardeau
Cape Girardeau

State

MO
MO

Postal Code

63703-5725
63703-5725

Country

US
US

Telephone Number

(573) 382-2127
(573) 332-0808

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 04/07/2014

Provider Address

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