| NPI | 1619376332 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA E KUSIAK Owner 913-269-2088 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: KS 60886) |
| Enumeration Date | 2014-08-19 |
| Last Update Date | 2014-10-22 |