| NPI | 1285109710 |
|---|---|
| Other Name | SEAPORT FAMILY DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | BROOK A. DERENZY Owner 816-753-3737 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2018-10-11 |
| Last Update Date | 2025-09-02 |