NPI | 1558586404 |
---|---|
Entity Type | Organization |
Authorized Contact | JOE B WOMMACK Owner Dentist 620-421-0980 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: KS 5853) |
Enumeration Date | 2007-04-16 |
Last Update Date | 2020-08-22 |