| NPI | 1194238816 |
|---|---|
| Doing Business As | IMMEDIADENT |
| Entity Type | Organization |
| Authorized Contact | MONICA L LONG Manager Of Credentialing 913-428-1686 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2017-11-16 |
| Last Update Date | 2017-11-16 |