| NPI | 1346391695 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD D. DALLAM Owner 816-373-8800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: MO MO12689) |
| Enumeration Date | 2007-01-15 |
| Last Update Date | 2020-08-22 |