| NPI | 1558745950 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICK RYAN Dentist 573-445-9526 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MO 2006014447) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MO 2002016155) |
| Enumeration Date | 2015-07-15 |
| Last Update Date | 2015-07-15 |