| NPI | 1730460270 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER J HAGGERTY Member 816-554-8300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: MO 2008034915) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MO 2002013152) |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: KS 60577) | |
| 204E00000X Oral & Maxillofacial Surgery (Licence: KS 04-34622) | |
| Enumeration Date | 2011-08-29 |
| Last Update Date | 2011-08-29 |