| NPI | 1811501570 |
|---|---|
| Doing Business As | CROWN JEWEL DENTAL LOFT |
| Entity Type | Organization |
| Authorized Contact | ANDREA SIDLE Dds 816-215-2904 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2020-09-01 |
| Last Update Date | 2021-08-09 |