| NPI | 1902042716 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT M CRITTENDEN Owner 785-273-9717 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: KS 60603) |
| Additional Taxonomies | 302F00000X Exclusive Provider Organization (Licence: KS 60603) |
| Enumeration Date | 2008-12-29 |
| Last Update Date | 2008-12-29 |