| NPI | 1639310964 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GINA HASKETT Office Manager 913-317-6453 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: KS 6144) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: KS 60076) |
| Enumeration Date | 2009-03-17 |
| Last Update Date | 2009-03-17 |