| NPI | 1205081379 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN T MEARS Dentist 636-464-6668 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: MO 2007010353) |
| Enumeration Date | 2008-11-17 |
| Last Update Date | 2008-11-17 |