| NPI | 1558453936 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICHOLAS WILLIAM KANAKARES Dentist President 913-829-4099 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: KS KS4690) |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2020-08-22 |