| NPI | 1578029021 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD D DALLAM Dentist 913-649-0310 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2019-02-20 |
| Last Update Date | 2019-02-20 |