| NPI | 1720117054 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSE G. MAIZE President 816-554-3400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MO 10665) |
| Enumeration Date | 2007-03-04 |
| Last Update Date | 2012-08-20 |