| NPI | 1245913235 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TATE ANDREWS CFO 816-388-0985 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics |
| 1223P0700X Dentist, Prosthodontics | |
| Enumeration Date | 2023-08-08 |
| Last Update Date | 2023-08-08 |