| NPI | 1407127004 |
|---|---|
| Other Name | CITADEL DENTAL GROUP KC MO |
| Entity Type | Organization |
| Authorized Contact | JAMES LARRY MCCREARY Dentist Owner Of Practice 816-523-4444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 126800000X Dental Assistant (Licence: MO 11801) |
| Additional Taxonomies | 126800000X Dental Assistant (Licence: MO 2006023201) |
| Enumeration Date | 2012-01-13 |
| Last Update Date | 2012-01-13 |