| NPI | 1558376384 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRAIG GRIDER President 816-246-9995 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MO DE 015889) |
| Enumeration Date | 2006-07-30 |
| Last Update Date | 2015-04-28 |