| NPI | 1548708878 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT T WHEATLEY Owner 636-947-6080 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MO 014347) |
| Enumeration Date | 2017-02-07 |
| Last Update Date | 2017-02-07 |