| NPI | 1730192469 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN PAUL ROTH President Owner 913-553-2492 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: KS 60313) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: KS 60313) |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2016-10-10 |