| NPI | 1730183716 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENDA LASATER-FINNEGAN Clinic Manager 816-231-3955 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MO 2003013101) |
| Enumeration Date | 2005-06-08 |
| Last Update Date | 2020-08-22 |