| NPI | 1962688952 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN B TRIMMELL Owner/Partner 316-260-6566 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2008-01-21 |
| Last Update Date | 2011-06-29 |