| NPI | 1770011926 |
|---|---|
| Doing Business As | ORAL AND MAXILLOFACIAL PROSTHODONTICS |
| Entity Type | Organization |
| Authorized Contact | ANN VITALE Practice Administrator 314-362-8574 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics |
| Enumeration Date | 2017-06-01 |
| Last Update Date | 2017-06-01 |