| NPI | 1295855930 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHIS BREWER Office Manager 636-532-3311 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MO 12505) |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2020-08-22 |