Organization
GREIF RUVINOV DENTAL CARE, LLC
Active
Other names
Brookside Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
STACY M MARTIN (OFFICE MANAGER)
(636) 240-1750
Entity
Organization
Contact information
Practice address
31 OFALLON SQ, O FALLON, MO 63366-3034
(636) 240-1750
(636) 389-5442
Mailing address
31 OFALLON SQ, O FALLON, MO 63366-3034
(636) 240-1750
(636) 389-5442
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
05/24/2018
Last updated
05/24/2018
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