| NPI | 1184130528 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TYMAN LOVELESS Owner / Surgeon 314-328-5995 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2017-12-21 |
| Last Update Date | 2017-12-21 |