| NPI | 1710072822 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHARON LEE MASON Owner/ Orthodontist 636-227-8713 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MO 015682) |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2020-08-22 |