| NPI | 1164712485 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL DOSTAL Sole Member 785-550-2682 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: KS 60656) |
| Enumeration Date | 2011-04-08 |
| Last Update Date | 2011-04-08 |