| NPI | 1568076701 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGE F BLAICH Dentist/Co Owner 573-785-0111 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2020-09-04 |
| Last Update Date | 2020-09-04 |