| NPI | 1619354545 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLI ELIZABETH GILL Office Manager 785-272-0770 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: KS 6357) |
| Additional Taxonomies | 122300000X Dentist (Licence: KS 60071) |
| 122300000X Dentist (Licence: KS 61063) | |
| Enumeration Date | 2015-04-29 |
| Last Update Date | 2015-04-29 |