# KC SMILE, P.A.

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

## Provider details

- **NPI number:** 1558433946
- **Authorized official:** DR. ROSS S HEADLEY DDS (OWNER)
- **Authorized official phone:** (913) 491-6874

## Contact information

- **Practice address:** 12850 METCALF AVE, STE 200, OVERLAND PARK, KS 66213-2622
- **Practice address phone:** (913) 491-6874
- **Practice address fax:** (913) 491-6917
- **Mailing address:** 12850 METCALF AVE, STE 200, OVERLAND PARK, KS 66213-2622
- **Mailing address phone:** (913) 491-6874
- **Mailing address fax:** (913) 491-6917

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 60571 | KS | — |
| 122300000X | Dentist | 6953 | KS | Yes |
| 1223G0001X | General Practice Dentistry | 5389 | KS | — |
| 1223G0001X | General Practice Dentistry | 6953 | KS | — |

## Other

- **Enumeration date:** 11/14/2006
- **Last updated:** 06/10/2014