NPI | 1578831244 |
---|---|
Entity Type | Organization |
Authorized Contact | VERNON G LEE Owner 620-365-6262 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: KS 4540) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: KS 60686) |
Enumeration Date | 2011-12-08 |
Last Update Date | 2013-01-16 |