| NPI | 1053568865 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KERRI L SMITH Office Manager 573-814-1694 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MO 015815) |
| Enumeration Date | 2008-08-22 |
| Last Update Date | 2008-08-22 |