| NPI | 1932255288 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD WILCOXON Owner President 913-661-9901 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: KS 6068) |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2020-08-22 |