| NPI | 1972724383 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK EDWARD TAYLOR Dentist 314-965-4064 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MO 015192) |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2013-02-27 |