| NPI | 1639567811 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH B. SCROGGINS President 314-965-3500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MO 2011021923) |
| Enumeration Date | 2014-12-23 |
| Last Update Date | 2014-12-23 |