| NPI | 1831363027 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT HABERKORN Dentist 573-334-6009 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MO 2002031756) |
| Enumeration Date | 2008-04-17 |
| Last Update Date | 2008-04-17 |