Individual
DR. GRAYDON L. BALLARD III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
168 N MERAMEC AVE, SUITE 102, SAINT LOUIS, MO 63105-3758
(314) 727-4900
(314) 727-9888
Mailing address
168 N MERAMEC AVE, SUITE 102, SAINT LOUIS, MO 63105-3758
(314) 727-4900
(314) 727-9888
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
014416
MO
Other
Enumeration date
08/31/2006
Last updated
10/30/2007
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