| NPI | 1184069007 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON WILLIAMS ANKENBRANDT Owner 636-219-3963 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MO 2002015114) |
| Enumeration Date | 2013-05-06 |
| Last Update Date | 2013-05-06 |