| NPI | 1356413611 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAQUELINE ANNE DEMKO Orthodontist 314-576-4955 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MO 015993) |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2020-08-22 |