| NPI | 1669688750 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VANESSA NICOLE KELLER President Owner 314-725-4343 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: MO 11994) |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2015-08-04 |