| NPI | 1265777064 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LIZ H ELMORE Office Manager 620-665-5582 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: KS 6348) |
| Enumeration Date | 2012-12-05 |
| Last Update Date | 2012-12-05 |