| NPI | 1407281314 |
|---|---|
| Doing Business As | O'FALLON MODERN DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | ALEX R SHARIFIAN Owner 636-379-7552 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2013-09-10 |
| Last Update Date | 2013-09-10 |