| NPI | 1700856762 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALLEN BLEY REAVIS President 913-367-0212 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: KS 6084) |
| Enumeration Date | 2006-01-24 |
| Last Update Date | 2020-08-22 |