| NPI | 1427520790 |
|---|---|
| Doing Business As | FOREST TRAIL DENTAL CARE |
| Entity Type | Organization |
| Authorized Contact | ASHLY SUNSHINE Credentialing 636-362-4986 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2018-12-26 |
| Last Update Date | 2023-01-26 |