| NPI | 1275671109 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL V. SARLI Administrator 314-251-6725 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: MO 2005012885) |
| Enumeration Date | 2007-02-02 |
| Last Update Date | 2007-08-01 |