| NPI | 1790950582 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HAYWOOD LEE HAMBRICK Owner 816-523-7766 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MO 012136 / 591) |
| Enumeration Date | 2008-04-23 |
| Last Update Date | 2008-04-23 |