| NPI | 1083668933 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JON MICHAEL WOODRUFF Owner/President 316-684-7531 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: KS 6814) |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2020-08-22 |