NPI | 1174057178 |
---|---|
Entity Type | Organization |
Authorized Contact | KENNETH COLBERT President 573-775-2636 |
Organization Subpart ? | No |
Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: MO 013305) |
Enumeration Date | 2017-04-17 |
Last Update Date | 2017-04-17 |