Provider Demographics
NPI:1982965935
Name:ST HILLAIRE, ..CHRIS NARVELLO (DDS)
Entity Type:Individual
Prefix:DR
First Name:..CHRIS
Middle Name:NARVELLO
Last Name:ST HILLAIRE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8695 MEADOW LN
Mailing Address - Street 2:
Mailing Address - City:BERRIEN SPRINGS
Mailing Address - State:MI
Mailing Address - Zip Code:49103-1426
Mailing Address - Country:US
Mailing Address - Phone:269-815-3076
Mailing Address - Fax:
Practice Address - Street 1:123 MARMONT ST
Practice Address - Street 2:
Practice Address - City:NILES
Practice Address - State:MI
Practice Address - Zip Code:49120-1657
Practice Address - Country:US
Practice Address - Phone:269-683-6461
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-06
Last Update Date:2012-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901020217122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist