| NPI | 1821213620 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN NELSON FOX Owner 573-785-1466 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MO 12904) |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2020-08-22 |