| NPI | 1902207426 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES DANIEL HURLEY Dentist 314-731-7555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: MO 2014015546) |
| Enumeration Date | 2014-09-16 |
| Last Update Date | 2014-09-16 |