| NPI | 1245742204 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS DEAN SOTIROPOULOS Owner 618-444-3274 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: MO 2017028549) |
| Enumeration Date | 2017-10-31 |
| Last Update Date | 2022-09-06 |