Organization
PROVIDE DENTAL
Active
Other names
Provide Dental- Chesterfield
Organization subpart
No
Provider details
NPI number
Authorized official
PHILIP SON DMD (OWNER/ GENERAL DENTIST)
(323) 787-9397
Entity
Organization
Contact information
Practice address
14377 WOODLAKE DR STE 205, CHESTERFIELD, MO 63017-5735
(314) 576-0088
Mailing address
2211 OLIVE ST STE 100, SAINT LOUIS, MO 63103-1502
(314) 776-7100
(314) 776-7469
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
07/15/2025
Last updated
07/15/2025
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