| NPI | 1295965309 |
|---|---|
| Doing Business As | DENTAL CLINIC |
| Entity Type | Organization |
| Authorized Contact | SEAN EIFERT Administrator 618-664-1442 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251K00000X Public Health or Welfare |
| Enumeration Date | 2009-07-23 |
| Last Update Date | 2017-06-07 |