| NPI | 1164455242 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HUGH HERSCHEL BRUNER President 913-469-1612 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist Periodontics (Licence: KS 4109) |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2020-08-22 |