| NPI | 1750611844 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN ARTHUR SHANKER Doctor 314-842-4105 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2010-01-12 |
| Last Update Date | 2010-01-12 |