| NPI | 1649622341 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TOBY BARNETT Chief Financial Officer 573-632-0243 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2016-07-06 |
| Last Update Date | 2016-07-06 |