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Individual

DR. JACLYN MICHELLE SCROGGINS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
D.M.D., M.S.

Contact information

Practice address
209 S KIRKWOOD RD, KIRKWOOD, MO 63122-4305
(314) 821-1101
Mailing address
12246 BENT SPRINGS DR, SAINT LOUIS, MO 63122-2117
(630) 707-1484

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
019.028002
IL
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
2012041113
MO

Other

Enumeration date
06/23/2009
Last updated
03/15/2017
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