| NPI | 1255749388 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LETRISHA ANN THOMAS President/Director 573-446-3848 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MO 2010019430) |
| Enumeration Date | 2014-08-01 |
| Last Update Date | 2014-11-05 |