NPI | 1346598661 |
---|---|
Entity Type | Organization |
Authorized Contact | BYRON V DUVALL Owner 314-776-7100 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Additional Taxonomies | 1223E0200X Dentist, Endodontics |
1223P0221X Dentist, Pediatric Dentistry | |
1223P0300X Dentist, Periodontics | |
1223P0700X Dentist, Prosthodontics | |
Enumeration Date | 2012-08-16 |
Last Update Date | 2012-08-16 |