| NPI | 1942551247 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW ROBERT HLAVACEK Owner/Operator 816-286-4126 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MO 016083) |
| Enumeration Date | 2012-09-26 |
| Last Update Date | 2012-10-24 |