| NPI | 1093937518 |
|---|---|
| Doing Business As | WEST EDGEWOOD DENTAL, VANDERVEEN DENTAL |
| Entity Type | Organization |
| Authorized Contact | NELSON HENRY Dds 573-634-2222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MO 016072) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2020-08-22 |