# WALDO ORAL SURGERY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Waldo Dental Care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1821586603
- **Authorized official:** MRS. ALICIA A TAMBURELLO (REGIONAL MANAGER OF BILLING & INS)
- **Authorized official phone:** (816) 830-9030

## Contact information

- **Practice address:** 8043 WORNALL RD STE 201, KANSAS CITY, MO 64114-5822
- **Practice address phone:** (816) 214-8339
- **Practice address fax:** (816) 216-1742
- **Mailing address:** 8043 WORNALL RD STE 201, KANSAS CITY, MO 64114-5822
- **Mailing address phone:** (816) 214-8339
- **Mailing address fax:** (816) 216-1742

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 2016011725 | MO | Yes |

## Other

- **Enumeration date:** 04/26/2018
- **Last updated:** 04/26/2018