| NPI | 1811069867 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM THOMAS PROSSER Dentist Owner 636-528-2572 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MO 013245) |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2020-08-22 |