| NPI | 1932384393 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN M. KILLIAN President 636-970-2699 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: MO 14633) |
| Enumeration Date | 2008-01-04 |
| Last Update Date | 2008-01-04 |