| NPI | 1417612904 |
|---|---|
| Doing Business As | GENNAOUI FAMILY DENTAL |
| Entity Type | Organization |
| Authorized Contact | TARA REES Treatment Coordinator 314-821-4410 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2021-11-01 |
| Last Update Date | 2021-11-01 |