| NPI | 1366657405 |
|---|---|
| Doing Business As | ST. LOUIS SOUTH ORAL & MAXILLOFACIAL SURGERY, INC. |
| Entity Type | Organization |
| Authorized Contact | PEGGY S. CAROTHERS Office Manager 314-842-4699 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MO 015277) |
| Enumeration Date | 2007-05-11 |
| Last Update Date | 2020-08-22 |