| NPI | 1912593591 |
|---|---|
| Other Name | WESTPORT DENTAL LLC |
| Entity Type | Organization |
| Authorized Contact | SHELLY BAHNER Office Manager 785-228-1280 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2020-12-17 |
| Last Update Date | 2020-12-17 |