| NPI | 1215207386 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID R RIES Owner 573-446-0700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MO 2008015521) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MO 13926) |
| Enumeration Date | 2012-01-06 |
| Last Update Date | 2012-01-06 |