| NPI | 1265711675 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALLEN BLEY REAVIS Director Of Dental Services/Dentist 913-367-0212 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2011-08-16 |
| Last Update Date | 2011-08-16 |