| NPI | 1134345093 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRI HUONG LY Dentist 314-865-3838 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: MO 200-101-1347) |
| Enumeration Date | 2007-04-18 |
| Last Update Date | 2020-08-22 |