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1760253694
PROVIDE DENTAL
SAINT LOUIS, MO
NPI
1760253694
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Entity Type
Organization
Authorized Contact
PHILIP SON
Owner/ General Dentist
323-787-9397
Organization Subpart ?
No
Primary Taxonomy
261QD0000X Clinic/Center, Dental
Enumeration Date
2024-01-10
Last Update Date
2024-01-10
Business Address
PROVIDE DENTAL
2211 OLIVE ST STE 100
SAINT LOUIS, MO 63103-1502
Phone number: 314-776-7100
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Mailing Address
PROVIDE DENTAL
2309 BARRETT PLACE CT
BALLWIN, MO 63021-7829
Phone number: 323-787-9397
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