Provider Demographics
NPI:1386918720
Name:CONTE, MARIO V (DMD)
Entity type:Individual
Prefix:DR
First Name:MARIO
Middle Name:V
Last Name:CONTE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 LADUE ESTATES DR
Mailing Address - Street 2:
Mailing Address - City:CREVE COEUR
Mailing Address - State:MO
Mailing Address - Zip Code:63141-8322
Mailing Address - Country:US
Mailing Address - Phone:314-567-7319
Mailing Address - Fax:
Practice Address - Street 1:2 LADUE ESTATES DR
Practice Address - Street 2:
Practice Address - City:CREVE COEUR
Practice Address - State:MO
Practice Address - Zip Code:63141-8322
Practice Address - Country:US
Practice Address - Phone:314-567-7319
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-02
Last Update Date:2012-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO013219122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist