| NPI | 1295254068 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY TULL Owner/Principal 913-254-4065 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2017-09-13 |
| Last Update Date | 2022-07-21 |