| NPI | 1992786412 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA M WELLS Associate Dean, Clinical Programs 816-235-2152 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: MO 2011013371) |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental (Licence: MO 11597) |
| Enumeration Date | 2005-11-10 |
| Last Update Date | 2017-03-10 |