| NPI | 1447463757 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CYRUS M ALIZADEH President 636-394-5455 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: MO 14488) |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2020-08-22 |