NPI | 1578850319 |
---|---|
Entity Type | Organization |
Authorized Contact | GEOFFREY CLARK RILEY Owner 816-332-2412 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MO 2007017280) |
Enumeration Date | 2011-06-30 |
Last Update Date | 2011-06-30 |