| NPI | 1871014738 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARBARA VAILAS Business Manager 316-634-1414 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery (Licence: KS 04-37299) |
| Enumeration Date | 2017-06-30 |
| Last Update Date | 2022-07-21 |