| NPI | 1902981319 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHERRY L FADDIS Bus. Mngr 913-649-5600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: KS 4936) |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2008-07-25 |