| NPI | 1972294726 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE MEDLEY Owner/Dentist 816-252-1590 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2023-05-15 |
| Last Update Date | 2023-05-15 |