| NPI | 1821076811 |
|---|---|
| Doing Business As | PARKCREST DENTAL GROUP |
| Entity Type | Organization |
| Authorized Contact | DANIEL S. FANNIN Vice President 417-887-1220 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2006-01-09 |
| Last Update Date | 2009-10-14 |