| NPI | 1871479758 |
|---|---|
| Doing Business As | PINE LAWN DENTAL |
| Entity Type | Organization |
| Authorized Contact | MICHAEL TRAVIS Owner 314-635-0822 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2025-08-14 |
| Last Update Date | 2025-08-14 |