| NPI | 1114303062 |
|---|---|
| Doing Business As | PERIODONTICS OF O'FALLON |
| Entity Type | Organization |
| Authorized Contact | SARAH CHRISTINA NORTHCOTT Owner/Periodontist 636-379-6905 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: MO 2007000508) |
| Enumeration Date | 2015-08-03 |
| Last Update Date | 2015-08-03 |