| NPI | 1689877094 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL THOMAS MATLOCK President 816-246-4920 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MO 015728) |
| Enumeration Date | 2007-06-06 |
| Last Update Date | 2020-08-22 |