| NPI | 1891987954 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA ANN SMITH Owner 636-239-7828 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MO 2004013254) |
| Enumeration Date | 2007-08-13 |
| Last Update Date | 2007-08-13 |