| NPI | 1891955050 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN ALLEN GARDNER Pediatric Dentist/President 573-443-2544 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: MO 10937) |
| Enumeration Date | 2008-06-11 |
| Last Update Date | 2008-06-11 |