| NPI | 1548321318 |
|---|---|
| Doing Business As | BRENTWOOD DENTAL GROUP |
| Entity Type | Organization |
| Authorized Contact | MICHAEL J. FADDIS Owner 314-962-6643 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2007-08-21 |