Organization
JOHN C. BOAIN, DDS DENTAL CARE, LLC
Active
Other names
Boain Dental Care
Organization subpart
No
Provider details
NPI number
Authorized official
TY JUSTICE (DIRECTOR, CREDENTIALING & PAYER REL)
(513) 808-4984
Entity
Organization
Contact information
Practice address
3001 LEMAY FERRY RD, SAINT LOUIS, MO 63125-3923
(314) 892-5343
(314) 892-6124
Mailing address
9825 KENWOOD RD STE 200, BLUE ASH, OH 45242-6252
(513) 609-4076
(513) 448-0511
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
04/08/2019
Last updated
03/12/2024
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