Individual
SONJA MARIE KETCHERSIDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
1500 PARK AVE, SAINT LOUIS, MO 63104-3024
(866) 626-2878
Mailing address
461 IVYWOOD DR, BALLWIN, MO 63011-2613
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
003119
MO
Other
Enumeration date
06/10/2026
Last updated
06/10/2026
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