Faye E Licata Dmd Fagd PC

NPI #1033295464 in Chesterfield, Missouri

Provider Information

NPI Number: 1033295464
Entity Type: Organization
Organization Name: Faye E Licata Dmd Fagd PC
Primary Specialty: Dentist
Enumeration Date: Oct 27, 2006
Last Updated: Jul 22, 2013

Practice Location

Address: 111 HILLTOWN VILLAGE CENTER
Address 2: SUITE #200
City: Chesterfield
State: Missouri
ZIP Code: 63017
Phone: (636) 532-2101

Authorized Official

Name: DR. FAYE E LICATA, DMD
Title: DENTIST OWNER
Phone: (636) 532-2101

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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