NPI | 1831349232 |
---|---|
Other Name | FENTON FAMILY DENTISTRY |
Entity Type | Organization |
Authorized Contact | JESSICA C. NIEVA Dentist/President 636-326-7633 |
Organization Subpart ? | No |
Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: MO 2002016551) |
Enumeration Date | 2008-09-23 |
Last Update Date | 2008-09-23 |