| NPI | 1518152883 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLI HENDERSON Owner/Manager 785-856-5600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: KS 60453) |
| Enumeration Date | 2007-09-10 |
| Last Update Date | 2007-10-04 |