| NPI | 1821150392 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID SCOTT KOERNER President 660-882-7097 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: MO 12714) |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2008-07-31 |