# STL DENTAL GROUP LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1235071317
- **Authorized official:** TRI LY (DENTIST)
- **Authorized official phone:** (314) 865-3838

## Contact information

- **Practice address:** 3654 GRAVOIS AVE, SAINT LOUIS, MO 63116-4728
- **Practice address phone:** (314) 865-3838
- **Practice address fax:** (314) 865-2419
- **Mailing address:** 3654 GRAVOIS AVE, SAINT LOUIS, MO 63116-4728
- **Mailing address phone:** (314) 865-3838
- **Mailing address fax:** (314) 865-2419

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 04/07/2026
- **Last updated:** 04/07/2026