| NPI | 1093818478 |
|---|---|
| Former Legal Business Name | SOUTHWIND ORAL AND FACIAL SURGERY |
| Entity Type | Organization |
| Authorized Contact | JARED DYE Owner 620-663-1141 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: KS 6423) |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2020-12-21 |