| NPI | 1184324873 |
|---|---|
| Doing Business As | STADIUM DENTAL CENTER |
| Entity Type | Organization |
| Authorized Contact | PAUL NOLAN CARDON Owner 573-636-5522 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2023-03-09 |
| Last Update Date | 2023-03-09 |