| NPI | 1053509281 |
|---|---|
| Doing Business As | IMMEDIADENT |
| Entity Type | Organization |
| Authorized Contact | AMY WHEELER Credentialing Coordinator 913-800-6952 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: OH 30-022131) |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2007-10-12 |
| Last Update Date | 2017-04-12 |