| NPI | 1760538649 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI ELIZABETH COCHELL President 314-910-8444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MO 2004013332) |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2008-07-09 |