| NPI | 1669196507 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JORDAN L ROSENTHAL Owner 913-226-8979 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2022-10-03 |
| Last Update Date | 2022-10-03 |