| NPI | 1992195234 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEHNAZ RAISDANA Owner Dentist 316-304-1582 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: KS 61092) |
| Enumeration Date | 2015-01-26 |
| Last Update Date | 2015-01-30 |