Provide Dental
NPI #1124990601 in Chesterfield, Missouri
Provider Information
- NPI Number
- 1124990601
- Entity Type
- Organization
- Organization Name
- Provide Dental
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- PROVIDE DENTAL
- Primary Specialty
- Clinic/Center - Dental
- Enumeration Date
- Sep 23, 2025
- Last Updated
- Sep 23, 2025
Practice Location
- Address
- 13371 OLIVE BLVD # 3108
- City
- Chesterfield
- State
- Missouri
- ZIP Code
- 63017-3108
- Phone
- (314) 878-5544
Authorized Official
- Name
- PHILIP SON, DMD
- Title
- DENTIST
- Phone
- (323) 787-9397
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Dental — Dental |
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