NPI | 1245367077 |
---|---|
Entity Type | Organization |
Authorized Contact | JERRY R LUNDGRIN President 785-825-5473 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: KS 4696) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: KS 6929) |
Enumeration Date | 2007-02-28 |
Last Update Date | 2020-08-22 |