| NPI | 1386219160 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA CHRISTINE ELLIS General Dentist/Partner 816-521-1312 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2021-05-24 |
| Last Update Date | 2021-05-24 |