| NPI | 1184721268 |
|---|---|
| Doing Business As | CRESTWOOD DENTAL GROUP |
| Entity Type | Organization |
| Authorized Contact | JAMES WILLIAM MAXWELL President 314-821-2134 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MO 2002029903) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2020-08-22 |