NPI | 1285054148 |
---|---|
Doing Business As | FAMILY DENTAL CARE OF OLATHE |
Entity Type | Organization |
Authorized Contact | EDMONDS LORI Credentialing Coordinator 217-540-8468 |
Organization Subpart ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Enumeration Date | 2014-04-18 |
Last Update Date | 2016-04-29 |