| NPI | 1003913104 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID GRANT SMITH Manager 816-436-2242 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MO 2001014186) |
| Additional Taxonomies | 122300000X Dentist (Licence: MO 014715) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2020-08-22 |