| NPI | 1740469014 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN LEE WILSON President 620-665-5200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: KS 6598) |
| Enumeration Date | 2007-11-02 |
| Last Update Date | 2007-11-02 |