| NPI | 1023161627 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW JUSTIN KRANER Dentist 636-887-3005 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MO 015457) |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2020-08-22 |