| NPI | 1720231848 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRANT KURTIS VOLLERTSEN Doctor Of Dental Surgery 620-275-4251 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: KS 60401) |
| Enumeration Date | 2008-11-03 |
| Last Update Date | 2008-11-03 |