| NPI | 1205255460 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRYAN SHEWANICK Dentist 816-454-1313 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: MO 2009016386) |
| Enumeration Date | 2014-04-15 |
| Last Update Date | 2014-04-15 |