| NPI | 1891133583 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANA DERDEUFF Owner/Dentist 573-356-4029 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MO 2012015356) |
| Enumeration Date | 2013-06-05 |
| Last Update Date | 2013-06-05 |