| NPI | 1528154184 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN CHARLES ROSENBERGER Corporate Secretary 314-839-9339 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MO 15250) |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2020-08-22 |