NPI | 1669609137 |
---|---|
Entity Type | Organization |
Authorized Contact | LISA S. KNUTZEN Vice President 417-623-6202 |
Organization Subpart ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: MO 014997) |
Enumeration Date | 2009-06-11 |
Last Update Date | 2009-06-11 |