| NPI | 1417161118 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELANIE K REED Office Administrator 620-241-6512 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: KS 5109) |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2020-08-22 |