| NPI | 1942592977 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDI C. GREEN Owner/ Dentist 417-887-5155 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MO 2011012315) |
| Enumeration Date | 2011-05-10 |
| Last Update Date | 2011-05-10 |