| NPI | 1831301340 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW BLAKE VAN BLARCOM President 913-649-4946 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: KS 60277) |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2020-08-22 |