| NPI | 1508022393 |
|---|---|
| Doing Business As | ST. LOUIS ORTHODONTIC GROUP |
| Entity Type | Organization |
| Authorized Contact | RICHARD GOLDBERG President 636-532-5535 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2008-08-01 |
| Last Update Date | 2008-08-01 |