| NPI | 1467693630 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANA HOLMAN Insurance Coordinator 417-623-2000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MO 11810) |
| Enumeration Date | 2009-03-17 |
| Last Update Date | 2009-03-17 |