| NPI | 1932568060 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRYAN PACE Business Manager 816-525-5414 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: MO 015384) |
| Enumeration Date | 2016-02-17 |
| Last Update Date | 2016-02-17 |