| NPI | 1497092050 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SVETLANA SOBOLEVSKAYA Dentist 913-402-0009 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: KS 60200) |
| Enumeration Date | 2013-01-15 |
| Last Update Date | 2013-01-15 |