| NPI | 1790899102 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CYNTHIA SHEPHERD Office Administrator 816-781-1430 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MO 014869) |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2008-06-17 |