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Organization

MICHAEL P. TRAVIS, DDS LLC

Active
Other names
Pine Lawn Dental
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MICHAEL PATRICK TRAVIS DDS (DENTIST)
(314) 382-2000
Entity
Organization

Contact information

Practice address
3721 JENNINGS STATION RD, SAINT LOUIS, MO 63121-3505
(314) 382-2000
Mailing address
3721 JENNINGS STATION RD, SAINT LOUIS, MO 63121-3505
(314) 382-2000

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2011019745
MO

Other

Enumeration date
05/27/2014
Last updated
05/27/2014
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