| NPI | 1417383852 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID GUILBEAULT Dentist 636-441-3430 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MO 2000174030) |
| Enumeration Date | 2013-09-17 |
| Last Update Date | 2015-05-28 |