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Organization
VILLAGE DENTAL, LLC
Active
Organization
VILLAGE DENTAL, LLC
Active
Other names
Village Dental- Claycomo
Organization subpart
No
Provider details
NPI number
Authorized official
AMY D KANNING (BUSINESS MANAGER)
(913) 908-9523
Entity
Organization
Contact information
Practice address
415 E US HIGHWAY 69, KANSAS CITY, MO 64119-3118
(816) 580-4191
Mailing address
415 E US HIGHWAY 69, KANSAS CITY, MO 64119-3118
(816) 263-3900
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
NULL
1223G0001X
General Practice Dentistry
Primary
—
—
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
11/30/2020
Last updated
06/10/2026
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