| NPI | 1053582189 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FAITH MILLER Dental Sealant Program Co Coordinat 618-453-7211 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2008-03-17 |
| Last Update Date | 2008-03-17 |