| NPI | 1629271564 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT E CARROLL Owner 573-365-6600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MO 13964) |
| Enumeration Date | 2007-06-07 |
| Last Update Date | 2020-08-22 |