| NPI | 1376607416 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD STEVEN CZEBRINSKI President Owner Surgeon 314-878-1401 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: MO MO GEN #011763) |
| Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery (Licence: MO MO SPEC #00483) |
| Enumeration Date | 2006-12-21 |
| Last Update Date | 2020-08-22 |