| 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 |