| NPI | 1285203265 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHERINE ELIZABETH WEYHAUPT Practice Manager 314-647-2828 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2021-06-23 |
| Last Update Date | 2021-06-23 |