| NPI | 1174640874 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT W FRY Owner 913-469-9191 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: KS 5293) |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2011-12-15 |