| NPI | 1497929004 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CYNTHIA ELLIOTT Administrative Assistant 913-722-0610 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: KS 6035) |
| Enumeration Date | 2008-04-15 |
| Last Update Date | 2008-04-15 |