| NPI | 1275960932 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THEODORE J MAPLE Dentist 620-356-1221 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: KS 4614) |
| Enumeration Date | 2013-09-26 |
| Last Update Date | 2013-09-26 |