| NPI | 1366848897 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOHAMMED REZA KHAKWANI General Dentist 316-727-6886 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: AZ D009075) |
| Enumeration Date | 2014-11-11 |
| Last Update Date | 2014-11-11 |