| Provide Dental | |
|
14377 Woodlake Dr Ste 205 Chesterfield MO 63017-5735 | |
| (314) 576-0088 | |
| Not Available |
| Full Name | Provide Dental |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 14377 Woodlake Dr Ste 205, Chesterfield, Missouri |
| Authorized Official Name and Position | Philip Son (OWNER/ GENERAL DENTIST) |
| Authorized Official Contact | 3237879397 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Provide Dental 2211 Olive St Ste 100 Saint Louis MO 63103-1502 Ph: (314) 776-7100 | Provide Dental 14377 Woodlake Dr Ste 205 Chesterfield MO 63017-5735 Ph: (314) 576-0088 |
| NPI Number | 1952292005 |
|---|---|
| Provider Enumeration Date | 07/15/2025 |
| Last Update Date | 07/15/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952292005 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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