| NPI | 1366594087 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD LEO KEITH President 913-384-0044 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: KS 6484) |
| Additional Taxonomies | 122300000X Dentist (Licence: KS 5953) |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2017-04-24 |