| NPI | 1285887448 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY MICHAEL O'BRYAN Manager 573-756-4344 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: MO 2006015354) |
| Enumeration Date | 2008-10-30 |
| Last Update Date | 2008-10-30 |