| NPI | 1023258936 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL R LEUCHTMANN Owner 636-916-4848 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: MO 2010021038) |
| Enumeration Date | 2009-03-05 |
| Last Update Date | 2012-06-20 |