| NPI | 1922782218 |
|---|---|
| Doing Business As | SOUTHPORT DENTAL |
| Entity Type | Organization |
| Authorized Contact | LEONARD DAVID WILLIAMS President 316-323-7933 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2023-06-15 |
| Last Update Date | 2023-06-15 |