NPI | 1275656480 |
---|---|
Entity Type | Organization |
Authorized Contact | STEPHEN GERARD NIKODEM Orthodontist 314-894-1311 |
Organization Subpart ? | No |
Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MO de015579) |
Enumeration Date | 2007-04-10 |
Last Update Date | 2020-08-22 |