| NPI | 1265598676 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK V MORRELL Doctor 636-441-5777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MO 13333) |
| Enumeration Date | 2006-12-29 |
| Last Update Date | 2020-08-22 |