| NPI | 1023557766 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY ANN PICKARD Owner 417-625-1114 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2017-02-14 |
| Last Update Date | 2017-02-14 |