NPI | 1285623504 |
---|---|
Entity Type | Organization |
Authorized Contact | ANTHONY MICHAEL GADBOIS Doctor 573-446-0880 |
Organization Subpart ? | No |
Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: MO 2000158124) |
Additional Taxonomies | 1223G0001X Dentist, General Practice |
Enumeration Date | 2005-10-19 |
Last Update Date | 2024-09-29 |