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Organization
SOUTH COUNTY DENTAL IMAGING CENTER
Active
Organization
SOUTH COUNTY DENTAL IMAGING CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN R MONTERUBIO SR. DDS (PRESIDENT)
(314) 721-1010
Entity
Organization
Contact information
Practice address
12818 TESSON FERRY RD, SUITE 204, SAINT LOUIS, MO 63128-2945
(314) 722-2033
(314) 842-1590
Mailing address
1034 S BRENTWOOD BLVD, SUITE 1010, SAINT LOUIS, MO 63117-1223
(314) 721-1010
(314) 721-5276
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
—
NULL
Other
Enumeration date
10/27/2009
Last updated
10/27/2009
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