| NPI | 1942795976 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VANESSA RENEE AXELSEN Owner 913-232-2708 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: KS 719) |
| Enumeration Date | 2018-06-22 |
| Last Update Date | 2022-10-18 |