| NPI | 1326301359 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATIE DAWN PETERSON President 417-926-4910 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MO 2012015429) |
| Enumeration Date | 2012-06-25 |
| Last Update Date | 2012-06-25 |