| NPI | 1942557368 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS G LAKEBRINK Owner/Dentist 816-792-4455 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MO 14423) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MO 2011014525) |
| Enumeration Date | 2012-08-06 |
| Last Update Date | 2012-08-06 |