Individual
PETER JOHN DURSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
11810 GRAVOIS, ST LOUIS, MO 63127
(314) 842-5000
Mailing address
11810 GRAVOIS, SUITE 104, ST LOUIS, MO 63127
(314) 842-5000
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
011726
MO
Other
Enumeration date
03/21/2006
Last updated
07/08/2007
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