| NPI | 1861901639 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY ANN RESZ Office Administrator 913-782-2231 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: KS 6899) |
| Additional Taxonomies | 122300000X Dentist (Licence: KS 7126) |
| 122300000X Dentist (Licence: KS 60308) | |
| 122300000X Dentist (Licence: KS 60739) | |
| 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment | |
| Enumeration Date | 2017-09-25 |
| Last Update Date | 2022-07-21 |