Provider Demographics
NPI:1780040998
Name:VERMA, MINAAL
Entity Type:Individual
Prefix:DR
First Name:MINAAL
Middle Name:
Last Name:VERMA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11816 CRAIG MANOR DR
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63146-5496
Mailing Address - Country:US
Mailing Address - Phone:973-454-7027
Mailing Address - Fax:
Practice Address - Street 1:11816 CRAIG MANOR DR
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63146-5496
Practice Address - Country:US
Practice Address - Phone:973-454-7027
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-05
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010217391223P0700X
MO20190009671223P0700X
IL0190320481223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics