Provider Demographics
NPI:1194162099
Name:MONESTERO, ANDREA (DDS)
Entity type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:
Last Name:MONESTERO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6232 SOUTHWOOD AVE
Mailing Address - Street 2:UNIT #1
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63105-3246
Mailing Address - Country:US
Mailing Address - Phone:618-954-9034
Mailing Address - Fax:
Practice Address - Street 1:10000 WATSON RD
Practice Address - Street 2:SUITE J
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63126-1841
Practice Address - Country:US
Practice Address - Phone:314-821-2134
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-31
Last Update Date:2016-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.029458122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist