| NPI | 1205966611 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL J O'CONNELL Owner 314-567-1600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MO 14226) |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2020-08-22 |