Individual
DR. BALASUDHA BALADHANDAYUTHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BDS, MSD
Contact information
Practice address
1500 PARK AVE, SAINT LOUIS, MO 63104-3024
(866) 626-2878
Mailing address
3534 GRATIOT ST APT 612, SAINT LOUIS, MO 63103-2957
(205) 422-0265
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401418600
VA
1223E0200X
Endodontics
IA-0008154045
MO
Other
Enumeration date
03/13/2012
Last updated
10/28/2025
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