| NPI | 1801978101 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS CHARLES EWING Owner 314-487-0333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: MO 12257) |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2008-10-02 |