| NPI | 1023027836 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARLA L SELLERS Office Manager 913-381-5194 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2022-07-21 |