| NPI | 1366646622 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAWRENCE JAY LEVENS Orthodontist 314-872-3218 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: MO 014562) |
| Enumeration Date | 2007-06-12 |
| Last Update Date | 2020-08-22 |