| NPI | 1073648622 |
|---|---|
| Doing Business As | IMMEDIADENT |
| Entity Type | Organization |
| Authorized Contact | AMY WHEELER Credentialing Coordinator 913-800-6952 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 122300000X Dentist (Licence: OH 22001) |
| Enumeration Date | 2007-02-23 |
| Last Update Date | 2017-04-12 |