Organization
PERIODONTAL CARE WEST LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ASHLEY JOHNSON (DIRECTOR OF OPERATIONS)
(913) 379-9498
Entity
Organization
Contact information
Practice address
975 N MUR LEN RD STE A, OLATHE, KS 66062-1803
(913) 415-2000
(913) 415-2004
Mailing address
975 N MUR LEN RD STE A, OLATHE, KS 66062-1803
(913) 415-2000
(913) 415-2004
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
—
—
Other
Enumeration date
05/24/2023
Last updated
05/24/2023
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