| NPI | 1992387559 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUMAN GORANTLA Orthodontist/Partner 316-684-5184 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2021-04-23 |
| Last Update Date | 2021-04-23 |