| NPI | 1629229059 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICAH A POPE Dentist 816-587-5655 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: MO 2003011279) |
| Enumeration Date | 2008-10-03 |
| Last Update Date | 2008-10-03 |