| NPI | 1639237274 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM J MILLER Owner Partner 314-838-3033 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MO 2001014860) |
| Additional Taxonomies | 122300000X Dentist (Licence: MO 11910) |
| 122300000X Dentist (Licence: MO 2000167581) | |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2008-07-25 |