Most Relevant Information
Provider Data
| NPI Number: | 1003177601 |
| Provider Name: | DOMINIQUE GLENNON HARTER DDS |
| Entity Type: | Individual |
| Taxonomy Code: | 122300000X |
| Specialty: | Dentist |
| License Number: | 2012015480 |
Most Important Dates
| Enumeration Date: | 05/31/2012 |
| Last Updated: | 07/02/2014 |
Provider Practice Location
2857 INDEPENDENCE ST
CAPE GIRARDEAU
MO
637035015
Practice Location Phone/Fax
| Phone: | 5733354646 |
| Fax: |
Provider Mailing Location
2857 INDEPENDENCE ST
CAPE GIRARDEAU
MO
637035015
Provider Mailing Phone/Fax
| Phone: | 5733354646 |
| Fax: |