| NPI | 1366888331 |
|---|---|
| Doing Business As | THREE RIVERS DENTAL |
| Entity Type | Organization |
| Authorized Contact | AMY GIBBONS Operations Manager 618-248-2038 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MO 2000174030) |
| Enumeration Date | 2013-05-17 |
| Last Update Date | 2014-02-24 |