| NPI | 1407817588 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA RAE MCCALL Practice Manager 573-642-6904 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MO 011961) |
| Enumeration Date | 2006-03-29 |
| Last Update Date | 2020-08-22 |