| NPI | 1477758563 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROCKY LUPARDUS President 636-938-4450 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: MO DE 015475) |
| Enumeration Date | 2007-06-19 |
| Last Update Date | 2020-08-22 |