| NPI | 1285465120 |
|---|---|
| Doing Business As | SOUTHTOWN FAMILY DENTAL |
| Entity Type | Organization |
| Authorized Contact | RICHARD S CAMPOS Owner/Dentist 573-201-9262 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2024-08-12 |
| Last Update Date | 2024-08-12 |