| NPI | 1245498930 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES RIES Owner 636-230-6100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MO 2004015776) |
| Enumeration Date | 2008-05-29 |
| Last Update Date | 2008-05-29 |