NPI | 1023473824 |
---|---|
Entity Type | Organization |
Authorized Contact | ALAN MCDAVID Owner/Partner 573-694-5081 |
Organization Subpart ? | No |
Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
Additional Taxonomies | 122300000X Dentist |
1223G0001X Dentist, General Practice | |
Enumeration Date | 2015-12-21 |
Last Update Date | 2017-01-27 |