| NPI | 1134393747 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW J. KRANER Member, LLC 636-887-3005 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MO 2006015457) |
| Enumeration Date | 2008-04-15 |
| Last Update Date | 2008-04-15 |