| NPI | 1306935986 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DUANE CLAY KELLER President 314-638-4190 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2020-08-22 |