| NPI | 1396918140 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICHOLAS P KAMAKAS Owner 314-727-7435 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MO 12839) |
| Additional Taxonomies | 122300000X Dentist (Licence: MO 010913) |
| Enumeration Date | 2008-04-11 |
| Last Update Date | 2015-03-24 |