| NPI | 1174936488 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA GEORGE Business Manager 816-525-5257 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MO 015727) |
| Additional Taxonomies | 122300000X Dentist (Licence: MO 2007037234) |
| Enumeration Date | 2014-06-04 |
| Last Update Date | 2014-06-04 |