| NPI | 1841009438 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT WELDON THOMPSON Dentist 314-635-0822 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery | |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics | |
| 1223X2210X Dentist, Orofacial Pain | |
| Enumeration Date | 2025-01-07 |
| Last Update Date | 2025-01-28 |