| NPI | 1154725745 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEREMY KIERSZ Owner/President 573-364-1599 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MO 015882) |
| Enumeration Date | 2014-10-10 |
| Last Update Date | 2014-10-10 |