NPI | 1245230374 |
---|---|
Entity Type | Organization |
Authorized Contact | PAMELA RAE MCCULLOUGH President 316-283-0870 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: KS 6191) |
Enumeration Date | 2005-07-29 |
Last Update Date | 2013-08-27 |