| NPI | 1609061233 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCIA LYNN PRESTON Dentist 417-732-7874 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: MO 2002011186) |
| Enumeration Date | 2007-09-06 |
| Last Update Date | 2008-06-19 |