| 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 |