| NPI | 1194292144 |
|---|---|
| Doing Business As | STADIUM DENTAL |
| Entity Type | Organization |
| Authorized Contact | RAY WEBER Support Specialist 314-753-8154 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2018-10-29 |
| Last Update Date | 2018-10-29 |