| NPI | 1053659508 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY NGUYEN Dentist 316-612-7777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: KS 7142) |
| Enumeration Date | 2013-01-17 |
| Last Update Date | 2013-01-17 |