| Jack D. Griffin, Jr. D.m.d., Lake St. Louis, Llc | |
|
1000 Lake Saint Louis Blvd Lake St Louis MO 63367-1340 | |
| (314) 488-1201 | |
| Not Available |
| Full Name | Jack D. Griffin, Jr. D.m.d., Lake St. Louis, Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1000 Lake Saint Louis Blvd, Lake St Louis, Missouri |
| Authorized Official Name and Position | Jack Griffin (OWNER) |
| Authorized Official Contact | 3144881201 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jack D. Griffin, Jr. D.m.d., Lake St. Louis, Llc 336 Barn Side Ln Eureka MO 63025-1650 Ph: () - | Jack D. Griffin, Jr. D.m.d., Lake St. Louis, Llc 1000 Lake Saint Louis Blvd Lake St Louis MO 63367-1340 Ph: (314) 488-1201 |
| NPI Number | 1780134569 |
|---|---|
| Provider Enumeration Date | 10/05/2016 |
| Last Update Date | 10/05/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780134569 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 014900 (Missouri) | Primary |
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