| NPI | 1013229749 |
|---|---|
| Doing Business As | OTTO BEAN DENTAL CLINIC |
| Entity Type | Organization |
| Authorized Contact | CHRIS JONES Chief Executive Officer 573-748-2404 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2010-07-10 |
| Last Update Date | 2014-08-06 |