| NPI | 1659013712 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN J PRSTOJEVICH Owner 816-820-4411 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center Oral and Maxillofacial Surgery |
| Enumeration Date | 2022-04-10 |
| Last Update Date | 2022-04-10 |