| NPI | 1104319862 |
|---|---|
| Other Name | COPPER CREEK DENTAL |
| Entity Type | Organization |
| Authorized Contact | JONATHAN W JACOBY Dentist 816-863-7096 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: MO 2015016758) |
| Enumeration Date | 2018-06-07 |
| Last Update Date | 2018-06-07 |