| NPI | 1558883181 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNE E PETERSON Business Manager 913-681-8100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: MO 2010016137) |
| Enumeration Date | 2017-07-14 |
| Last Update Date | 2018-03-17 |