| NPI | 1043369101 |
|---|---|
| Doing Business As | LINCOLN COUNTY DENTAL LLC |
| Entity Type | Organization |
| Authorized Contact | JUSTIN BRYAN SHORT Dentist 314-406-8202 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MO 2005026026) |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2020-08-22 |