| NPI | 1942636592 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRA LYNN REUSSER Dentist/Owner 316-249-3929 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: KS 7171) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: KS 7010) |
| Enumeration Date | 2013-09-15 |
| Last Update Date | 2013-09-15 |