# PEDIATRIC DENTAL SPECIALISTS, PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083943963
- **Authorized official:** ALICE WEBSTER (OFFICE MANAGER)
- **Authorized official phone:** (816) 741-8881

## Contact information

- **Practice address:** 209 NE BARRY RD, KANSAS CITY, MO 64155-2721
- **Practice address phone:** (816) 741-8881
- **Practice address fax:** (816) 741-0585
- **Mailing address:** 209 NE BARRY RD, KANSAS CITY, MO 64155-2721
- **Mailing address phone:** (816) 741-8881
- **Mailing address fax:** (816) 741-0585

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | 015672 | MO | Yes |

## Other

- **Enumeration date:** 12/23/2009
- **Last updated:** 12/23/2009