| NPI | 1861021826 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN KOHLMEIER Owner 620-481-1452 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2020-04-02 |
| Last Update Date | 2021-03-08 |