NPI | 1215004601 |
---|---|
Entity Type | Organization |
Authorized Contact | DAVID M NEAL President 660-646-4352 |
Organization Subpart ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: MO 013568) |
Additional Taxonomies | 122300000X Dentist (Licence: MO 015513) |
Enumeration Date | 2006-11-29 |
Last Update Date | 2020-08-22 |