| NPI | 1497012702 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH ELWYN BEAN Owner/ Dentist 620-424-4499 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: KS 5513) |
| Enumeration Date | 2012-04-12 |
| Last Update Date | 2012-04-12 |