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Organization
SONU MUTHUVALLIAPPAN 3 DMD LLC
Active
Organization
SONU MUTHUVALLIAPPAN 3 DMD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BENJAMIN E TUINEI (CREDENTIALING MANAGER)
(888) 808-4513
Entity
Organization
Contact information
Practice address
4305 BUTLER HILL RD, SAINT LOUIS, MO 63128-3702
(314) 892-8060
Mailing address
4305 BUTLER HILL RD, SAINT LOUIS, MO 63128-3702
(314) 892-8060
Taxonomy
Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
Primary
—
NULL
1223D0001X
Public Health Dentistry
Primary
—
—
261QD0000X
Dental Clinic/Center
—
NULL
Other
Enumeration date
03/30/2021
Last updated
07/23/2021
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