NPI | 1821248162 |
---|---|
Entity Type | Organization |
Authorized Contact | AMY WHEELER Credentialing COO Rdinator 913-800-6952 |
Organization Subpart ? | Yes |
Primary Taxonomy | 122300000X Dentist |
Additional Taxonomies | 261QD0000X Clinic/Center Dental |
Enumeration Date | 2008-09-23 |
Last Update Date | 2017-04-12 |