Genmat Op, PA
Clinic/Center, Dental in Overland Park, KS. Organization (NPI-2).
NPI number1972080588
StatusActive
Last updated in NPPESMar 26, 2024
Details
- NPI
- 1972080588
- Entity type
- Organization (NPI-2)
- Legal business name
- Genmat Op, PA
- Organization subpart
- No
- Enumeration date
- Jul 26, 2018
- Certification date
- Mar 26, 2024
- Last updated
- Mar 26, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QD0000X | Clinic/Center, Dental | 61292 | KS | Yes |
Practice location
11044 Quivira RdOverland Park, KS 66210-1239
Phone 913-469-8010
Mailing address
12180 S 300 E Unit 270Draper, UT 84020-2612
Phone 913-469-8010
Authorized official
Mathew H Draper
Owner
3852156097
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