| NPI | 1609192301 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALLISON LEVANS Owner/Dentist 620-257-5104 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: KS 60590) |
| Additional Taxonomies | 122300000X Dentist (Licence: KS 3559) |
| Enumeration Date | 2010-04-20 |
| Last Update Date | 2010-05-27 |