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Organization
TOWNE DENTAL OF OAK GROVE LLC
Active
Organization
TOWNE DENTAL OF OAK GROVE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBORAH L WOLFF (CO OWNER)
(816) 214-6755
Entity
Organization
Contact information
Practice address
1206 S BROADWAY, OAK GROVE, MO 64075-9100
(816) 690-4141
Mailing address
4935 BLUE RIDGE BLVD, KANSAS CITY, MO 64133-2550
(816) 214-6755
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
12760
MO
Other
Enumeration date
01/05/2010
Last updated
01/05/2010
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