# FACIAL SURGERY GROUP PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Tanner and Moore
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194745620
- **Authorized official:** MRS. LOUANN ALLEN (PRACTICE MANAGER)
- **Authorized official phone:** (816) 561-1115

## Contact information

- **Practice address:** 4700 BELLEVIEW, STE L 10, KANSAS CITY, MO 64112-1360
- **Practice address phone:** (816) 561-1115
- **Practice address fax:** (816) 931-7912
- **Mailing address:** PO BOX 802752, KANSAS CITY, MO 64180-0001
- **Mailing address phone:** (816) 561-1115
- **Mailing address fax:** (816) 753-4493

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | DE015216 | MO | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | DE015905 | MO | Yes |

## Other

- **Enumeration date:** 07/20/2006
- **Last updated:** 08/22/2020