| NPI | 1770569659 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY DALIN President 314-567-3555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MO 13310) |
| Enumeration Date | 2005-12-21 |
| Last Update Date | 2013-02-12 |