| NPI | 1780136838 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KURT A. WEISENFELS Dentist 314-961-3244 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: MO 13075) |
| Enumeration Date | 2016-10-25 |
| Last Update Date | 2016-10-25 |