| NPI | 1083836381 |
|---|---|
| Doing Business As | TOOTH TRUCK |
| Entity Type | Organization |
| Authorized Contact | BONNIE KELLER President CEO 417-875-3503 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223D0001X Dentist, Dental Public Health (Licence: MO 200212097) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2020-08-22 |