| NPI | 1295964104 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ARTHUR T ENGELAGE Owner 618-233-3503 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: MO 2002007232) |
| Enumeration Date | 2009-07-13 |
| Last Update Date | 2009-07-13 |