Southside Dental Care, L.l.c.
NPI #1134345093 in Saint Louis, Missouri
Provider Information
- NPI Number
- 1134345093
- Entity Type
- Organization
- Organization Name
- Southside Dental Care, L.l.c.
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Apr 18, 2007
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 3654 GRAVOIS AVE
- City
- Saint Louis
- State
- Missouri
- ZIP Code
- 63116-4728
- Phone
- (314) 865-3838
Authorized Official
- Name
- DR. TRI HUONG LY, D.D.S.
- Title
- DENTIST
- Phone
- (314) 865-3838
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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