| NPI | 1649783614 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICK COX Office Manger 573-446-6868 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: MT 15006) |
| Enumeration Date | 2017-11-13 |
| Last Update Date | 2018-06-16 |