| 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 |