| NPI | 1275556177 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT K REYNOLDS Owner 417-881-3220 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MO 015036) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MO 015949) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2020-08-22 |