| NPI | 1447419684 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SALLY K HEBERT President 314-521-5678 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: MO DE013034) |
| Enumeration Date | 2008-06-03 |
| Last Update Date | 2008-06-03 |