| NPI | 1649445321 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUELINE M. MILLER Orthodontist 636-239-4004 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: MO DE015380) |
| Enumeration Date | 2008-04-24 |
| Last Update Date | 2008-04-24 |