| NPI | 1194276238 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESLEE MILLER Office Manager 620-241-6512 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: KS KS60689) |
| Enumeration Date | 2016-10-24 |
| Last Update Date | 2022-11-23 |