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Organization
KC DENTAL CO LLC
Active
Organization
KC DENTAL CO LLC
Active
Other names
Mill Creek Dental
Organization subpart
No
Provider details
NPI number
Authorized official
MCKENZIE LEWIS (GENERAL MANAGER)
(816) 347-9933
Entity
Organization
Contact information
Practice address
3555 NE RALPH POWELL RD, LEES SUMMIT, MO 64064-2360
(816) 347-9933
Mailing address
3555 NE RALPH POWELL RD, LEES SUMMIT, MO 64064-2360
(816) 347-9933
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
NULL
Other
Enumeration date
04/17/2025
Last updated
04/17/2025
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