| NPI | 1215140033 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SALLY C POWELL President 573-474-8566 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MO 2001012816) |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2020-08-22 |