Organization
PEDIATRIC DENTAL SPECIALISTS, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALICE WEBSTER (OFFICE MANAGER)
(816) 741-8881
Entity
Organization
Contact information
Practice address
209 NE BARRY RD, KANSAS CITY, MO 64155-2721
(816) 741-8881
(816) 741-0585
Mailing address
209 NE BARRY RD, KANSAS CITY, MO 64155-2721
(816) 741-8881
(816) 741-0585
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
015672
MO
Other
Enumeration date
12/23/2009
Last updated
12/23/2009
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