| NPI | 1912062449 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL LEO YANG Owner 636-947-1057 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MO 014666) |
| Enumeration Date | 2006-12-26 |
| Last Update Date | 2020-08-22 |