| NPI | 1073887642 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREA T. GORDON Dentist 314-361-6767 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MO 013689) |
| Enumeration Date | 2012-02-29 |
| Last Update Date | 2012-02-29 |