| NPI | 1164986469 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEVI HANSEN President 316-652-5321 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2019-01-31 |
| Last Update Date | 2019-01-31 |