| NPI | 1790033538 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT C GOLDSTEIN Owner 417-845-6384 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MO 14374) |
| Enumeration Date | 2012-08-28 |
| Last Update Date | 2012-08-28 |