| NPI | 1316450398 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN WALLACE HOUGH President 636-391-1959 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MO 14304) |
| Enumeration Date | 2017-11-13 |
| Last Update Date | 2017-11-13 |