NPI | 1952775793 |
---|---|
Former Legal Business Name | LESTER C JOERN JR DDS PC |
Entity Type | Organization |
Authorized Contact | TYLER M AHOLT Owner 314-752-7468 |
Organization Subpart ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: MO 2012015662) |
Enumeration Date | 2015-11-17 |
Last Update Date | 2015-11-17 |