| NPI | 1235171059 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK EDWIN FLACK Oral Surgeon/Owner 816-229-3737 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MO 12700) |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2007-10-24 |