| NPI | 1013112234 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARRY BRACE Owner Dentist 314-965-6503 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MO 12409) |
| Enumeration Date | 2007-06-18 |
| Last Update Date | 2020-08-22 |