| NPI | 1912220773 |
|---|---|
| Other Name | ST. CHARLES MODERN DENTAL |
| Entity Type | Organization |
| Authorized Contact | KIANOR SHAHMOHMMADI CEO Nexus Dentistry 618-917-5808 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019027170) |
| Enumeration Date | 2010-03-09 |
| Last Update Date | 2010-03-09 |