| NPI | 1609233089 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SETH RUSH Periodontist 816-444-8822 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: MO 2012015447) |
| Enumeration Date | 2016-01-15 |
| Last Update Date | 2016-01-15 |