Individual
DR. KYLE Z BLACKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
11208 QUINCY AVE, KANSAS CITY, MO 64137-2504
(816) 763-8400
Mailing address
11208 QUINCY AVE, KANSAS CITY, MO 64137-2504
(816) 763-8400
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2016019236
MO
Other
Enumeration date
05/15/2017
Last updated
05/15/2017
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