| NPI | 1447904941 |
|---|---|
| Doing Business As | NIKODEM DENTAL HAZELWOOD |
| Entity Type | Organization |
| Authorized Contact | HANNAH MEEKS Ar Specialist 618-977-6931 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2022-02-04 |
| Last Update Date | 2022-04-01 |