| NPI | 1932565504 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRAVIS SCHWARZ Owner/Dentist 618-830-0958 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: MO 2011030941) |
| Enumeration Date | 2016-01-12 |
| Last Update Date | 2016-01-12 |