| 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 |