| NPI | 1972773364 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALAN M. STOLL President 573-248-0071 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MO 13715) |
| Enumeration Date | 2008-03-03 |
| Last Update Date | 2008-03-03 |