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Organization
PERIODONTAL CARE NORTH, LLC
Active
Organization
PERIODONTAL CARE NORTH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ASHLEY MARIE JOHNSON (DIRECTOR OF OPERATIONS)
(913) 379-9498
Entity
Organization
Contact information
Practice address
5707 NW 64TH TER, KANSAS CITY, MO 64151-2382
(816) 741-3830
(816) 741-2693
Mailing address
5707 NW 64TH TER, KANSAS CITY, MO 64151-2382
(816) 741-3830
(816) 741-2693
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
—
—
Other
Enumeration date
05/23/2023
Last updated
05/23/2023
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