| NPI | 1548445406 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CINDY M SOOTER Office Manager 573-817-2222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MO 2008006645) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MO 200613508) |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: MO 01348) | |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: MO 010435) | |
| Enumeration Date | 2008-01-09 |
| Last Update Date | 2008-06-17 |