| NPI | 1790806693 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN M CASSIDY Owner 785-233-0582 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: KS 6864) |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2020-08-22 |