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Organization
MY DENTIST WESTERN KC, PA
Active
Organization
MY DENTIST WESTERN KC, PA
Active
Parent organization
MY DENTIST WESTERN KC, PA
Other names
MyDentist-State Ave.
Organization subpart
Yes
Provider details
NPI number
Legal business name
MY DENTIST WESTERN KC, PA
Authorized official
KENDRA WALKER (CREDENTIALING COORDINATOR)
(217) 540-8312
Entity
Organization
Contact information
Practice address
7848 STATE AVE, KANSAS CITY, KS 66112-2417
(913) 299-1001
Mailing address
7848 STATE AVE, KANSAS CITY, KS 66112-2417
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
04/18/2014
Last updated
04/18/2014
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