| NPI | 1164550109 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NEVIN KENT WATERS President 913-782-1330 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: KS 5199) |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2020-08-22 |