# DENTAL INNOVATIONS, PA

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

## Provider details

- **NPI number:** 1427111095
- **Authorized official:** MARK W MANROE DDS (OWNER)
- **Authorized official phone:** (913) 236-8899

## Contact information

- **Practice address:** 11221 SHAWNEE MISSION PKWY, SHAWNEE, KS 66203-3333
- **Practice address phone:** (913) 236-8899
- **Practice address fax:** (913) 236-8717
- **Mailing address:** 11221 SHAWNEE MISSION PKWY, SHAWNEE, KS 66203-3333
- **Mailing address phone:** (913) 236-8899
- **Mailing address fax:** (913) 236-8717

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 6883 | KS | Yes |

## Other

- **Enumeration date:** 12/18/2006
- **Last updated:** 08/22/2020