| NPI | 1801139803 |
|---|---|
| Doing Business As | MID RIVERS DENTAL GROUP |
| Entity Type | Organization |
| Authorized Contact | DAVID GUILBEAULT Owner/Dentist 618-692-1110 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MO 2000174030) |
| Enumeration Date | 2013-03-28 |
| Last Update Date | 2014-11-05 |