| NPI | 1275892671 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW E ROBERTSON Owner 316-722-0800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: KS 60512) |
| Enumeration Date | 2012-05-07 |
| Last Update Date | 2012-06-20 |