# RED BRIDGE FAMILY DENTAL

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

## Provider details

- **NPI number:** 1619583895
- **Authorized official:** DR. PETER BENJAMIN MCCLELLAN DDS (CO-OWNER)
- **Authorized official phone:** (573) 230-6862

## Contact information

- **Practice address:** 400 E RED BRIDGE RD STE 321, KANSAS CITY, MO 64131-4031
- **Practice address phone:** (816) 943-0600
- **Mailing address:** 400 E RED BRIDGE RD STE 321, KANSAS CITY, MO 64131-4031

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 09/22/2020
- **Last updated:** 09/22/2020