| NPI | 1457411928 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REXANNA JO KNAPP Office Manager 620-232-2273 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: KS 60140) |
| Additional Taxonomies | 122300000X Dentist (Licence: KS 60336) |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2020-08-22 |