Organization
SOUTH COUNTY FAMILY DENTAL, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARL GRAVES (DDS)
(850) 712-2307
Entity
Organization
Contact information
Practice address
12660 LAMPLIGHTER SQUARE SHPG CTR STE G, SAINT LOUIS, MO 63128-2761
(314) 843-4040
Mailing address
12660 LAMPLIGHTER SQUARE SHPG CTR STE G, SAINT LOUIS, MO 63128-2761
(314) 843-4040
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
05/18/2021
Last updated
05/18/2021
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