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Organization

PROVIDE DENTAL

Active
Parent organization
PROVIDE DENTAL
Other names
Provide Dental- Chesterfield
Organization subpart
Yes

Provider details

NPI number
Legal business name
PROVIDE DENTAL
Authorized official
PHILIP SON DMD (DENTIST)
(323) 787-9397
Entity
Organization

Contact information

Practice address
13371 OLIVE BLVD # 3108, CHESTERFIELD, MO 63017-3108
(314) 878-5544
Mailing address
13371 OLIVE BLVD # 3108, CHESTERFIELD, MO 63017-3108
(314) 878-5544

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary

Other

Enumeration date
09/23/2025
Last updated
09/23/2025
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