| NPI | 1033579107 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COLLEEN NGUYEN Owner 913-788-0800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: KS 7141) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: KS 7141) |
| Enumeration Date | 2016-03-02 |
| Last Update Date | 2018-03-17 |