NPI | 1346099033 |
---|---|
Former Legal Business Name | MIKE MINTEN DDS GENERAL DENTISTRY |
Entity Type | Organization |
Authorized Contact | NICHOLAS JAY HARL Owning Dentist 573-443-5195 |
Organization Subpart ? | No |
Primary Taxonomy | 122300000X Dentist |
Enumeration Date | 2024-05-15 |
Last Update Date | 2024-05-15 |