| NPI | 1760599732 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANA KAY BAKER Office Manager 573-635-7216 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2008-01-31 |