Organization
VOYAGE03, LLC
Active
Other names
Northside Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
KIM JIMENEZ (OFFICE MANAGER)
(636) 431-8600
Entity
Organization
Contact information
Practice address
472 HIGHWAY P, O FALLON, MO 63366-1591
(636) 431-8600
(636) 215-8296
Mailing address
472 HIGHWAY P, O FALLON, MO 63366-1591
(636) 431-8600
(636) 215-8296
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
09/06/2023
Last updated
09/19/2023
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