NPI | 1922435148 |
---|---|
Entity Type | Organization |
Authorized Contact | MICHAEL CHASE KELLY Dentist 417-881-1213 |
Organization Subpart ? | No |
Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: MO 2013017374) |
Enumeration Date | 2013-10-02 |
Last Update Date | 2013-10-02 |