| NPI | 1235647850 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TYRENA L. BELL Office Manager 816-298-0090 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: MO 2012015475) |
| Enumeration Date | 2018-01-17 |
| Last Update Date | 2018-01-17 |