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Organization

BALLASDENTAL

Active
Parent organization
DENTAL
Organization subpart
Yes

Provider details

NPI number
Legal business name
DENTAL
Authorized official
JOY ANNETTE DAVIES (RECEPTIONIST)
(314) 432-5544
Entity
Organization

Contact information

Practice address
2821 N BALLAS RD STE 140, SAINT LOUIS, MO 63131-2377
(314) 432-5544
Mailing address
2821 N BALLAS RD STE 140, SAINT LOUIS, MO 63131-2377
(314) 432-5544

Taxonomy

Speciality
Code
Description
License number
State
284300000X
Special Hospital
Primary
11564
MO

Other

Enumeration date
12/21/2015
Last updated
12/21/2015
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