| NPI | 1265689673 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD T MARTENS Dentist/President 417-869-6487 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MO 015922) |
| Additional Taxonomies | 122300000X Dentist (Licence: MO 011444) |
| Enumeration Date | 2008-08-27 |
| Last Update Date | 2008-08-27 |