| NPI | 1992136923 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CODY BELL Owner 573-243-5200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MO 2011014478) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2013-12-02 |
| Last Update Date | 2013-12-02 |