NPI | 1861966921 |
---|---|
Entity Type | Organization |
Authorized Contact | TERRY DYER Owner 314-606-8383 |
Organization Subpart ? | No |
Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
Additional Taxonomies | 122300000X Dentist |
Enumeration Date | 2019-01-11 |
Last Update Date | 2019-01-11 |