| NPI | 1235771155 | 
|---|---|
| Doing Business As | SOUTH COUNTY COMPLETE DENTAL CARE | 
| Entity Type | Organization | 
| Authorized Contact | JAMES T. FETSCH Member 314-849-3234 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 1223G0001X Dentist, General Practice | 
| Enumeration Date | 2019-10-11 | 
| Last Update Date | 2019-10-11 |