| NPI | 1942313630 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRANK ANTHONY RUNCO President 314-352-4680 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: MO 14387) |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2020-08-22 |