| NPI | 1043788482 |
|---|---|
| Doing Business As | CHESTERFIELD WOODLAKE DENTAL |
| Entity Type | Organization |
| Authorized Contact | ANDREW ROGER BRUENING Manager 636-448-1085 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2018-11-03 |
| Last Update Date | 2018-11-03 |