Organization
KENNETH B. SCROGGINS, D.M.D., LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH B. SCROGGINS D.M.D. (PRESIDENT)
(314) 965-3500
Entity
Organization
Contact information
Practice address
11780 MANCHESTER RD, SUITE 105, SAINT LOUIS, MO 63131-4600
(314) 965-3500
(314) 965-7721
Mailing address
11780 MANCHESTER RD, SUITE 105, SAINT LOUIS, MO 63131-4600
(314) 965-3500
(314) 965-7721
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2011021923
MO
Other
Enumeration date
12/23/2014
Last updated
12/23/2014
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