| NPI | 1003948027 |
|---|---|
| Doing Business As | HAWTHORN DENTAL - ST. CHARLES |
| Entity Type | Organization |
| Authorized Contact | BRUCE STOLLE Co Owner Dentist 636-928-8400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2007-03-12 |
| Last Update Date | 2020-08-22 |