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 |