| NPI | 1780989061 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS VERALDI Owner 314-965-7630 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: MO 14227) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MO 14227) |
| Enumeration Date | 2011-01-19 |
| Last Update Date | 2011-01-19 |