| NPI | 1114279460 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KARI ANN HICKS Office Manager 417-501-1048 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: MO 2006012741) |
| Enumeration Date | 2012-10-11 |
| Last Update Date | 2016-06-01 |