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Organization
PERIODONTAL SPECIALIST PA
Active
Organization
PERIODONTAL SPECIALIST PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANIEL THOMAS DDS MS (OWNER/PERIODONTIST)
(913) 663-4867
Entity
Organization
Contact information
Practice address
11401 NALL AVENUE, LEAWOOD, KS 66211-1674
(913) 663-4867
Mailing address
11401 NALL AVENUE, LEAWOOD, KS 66211-1674
(913) 663-4867
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
—
—
Other
Enumeration date
07/13/2006
Last updated
07/17/2008
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