| NPI | 1396889853 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KURT EDWARD KAVANAUGH Owner 816-420-8100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MO 014547) |
| Enumeration Date | 2007-02-17 |
| Last Update Date | 2020-08-22 |