| NPI | 1770984668 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELINDA K MINER Owner 785-623-1857 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2014-09-10 |
| Last Update Date | 2014-09-10 |