| NPI | 1972040699 |
|---|---|
| Doing Business As | GRAIN VALLEY FAMILY DENTAL |
| Entity Type | Organization |
| Authorized Contact | PETER BENJAMIN MCCLELLAN Owner Dentist 573-230-6862 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MO 2010016286) |
| Enumeration Date | 2017-01-20 |
| Last Update Date | 2017-01-20 |