| NPI | 1538401237 |
|---|---|
| Doing Business As | SHOAL VALLEY DENTAL |
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER F WICK President 816-420-9070 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MO 2004015365) |
| Enumeration Date | 2013-03-20 |
| Last Update Date | 2013-03-20 |