| NPI | 1811773674 |
|---|---|
| Doing Business As | NORTHSIDE FAMILY DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | KIM JIMENEZ Office Manager 636-431-8600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2023-09-06 |
| Last Update Date | 2023-09-19 |