| NPI | 1952471351 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY P MAHER Board Member 314-822-2210 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: MO 015204) |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2012-05-08 |