| NPI | 1285896530 |
|---|---|
| Other Name | CORNELL THOMAS |
| Entity Type | Organization |
| Authorized Contact | DOROTHY J DEAVAULT Dental Assistant 314-389-9990 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MO 12970) |
| Enumeration Date | 2008-06-27 |
| Last Update Date | 2008-06-27 |