| NPI | 1306211586 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHEILA JUNGMEYER Co Owner 816-554-1600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MO 015446) |
| Additional Taxonomies | 122300000X Dentist (Licence: MO 2005017729) |
| 122300000X Dentist (Licence: MO 12727) | |
| Enumeration Date | 2015-12-14 |
| Last Update Date | 2015-12-14 |