| NPI | 1205989134 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARRY JOEL YUSMAN Member 636-441-9400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MO 11977) |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2020-08-22 |