| NPI | 1447359534 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN ANN GODWIN Oral Surgeon 636-532-3525 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MO 013223) |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2008-03-13 |