| NPI | 1891107132 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA ANDREWS Insurance Coordinator 314-361-0760 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2014-05-21 |
| Last Update Date | 2014-05-21 |