| NPI | 1013193028 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRYSTAL RACHELLE WALKER President 316-613-2077 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: KS 60282) |
| Enumeration Date | 2008-01-21 |
| Last Update Date | 2016-10-14 |