# KC DENTAL PROFESSIONALS, PA

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** KC DENTAL PROFESSIONALS, PA
- **Other names:** Deer Creek Family Dental Care
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1851526693
- **Legal business name:** KC DENTAL PROFESSIONALS, PA
- **Authorized official:** KIM WILSON (INSURANCE/CREDENTIALING)
- **Authorized official phone:** (217) 540-5100

## Contact information

- **Practice address:** 13328 METCALF AVE, OVERLAND PARK, KS 66213-2804
- **Practice address phone:** (913) 345-2273
- **Practice address fax:** (913) 345-8102
- **Mailing address:** 13328 METCALF AVE, OVERLAND PARK, KS 66213-2804

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 05/22/2009
- **Last updated:** 11/13/2012