Organization
AMAZING SMILES OF KANSAS CITY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY MCCRACKEN D.D.S. (DENTIST/OWNER)
(913) 788-7600
Entity
Organization
Contact information
Practice address
8915 STATE AVE, KANSAS CITY, KS 66112-1645
(913) 788-7600
(913) 788-7601
Mailing address
8915 STATE AVE, KANSAS CITY, KS 66112-1645
(913) 788-7600
(913) 788-7601
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
60811
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1780945279
NPI NUMBER
KS
Enumeration date
08/06/2012
Last updated
08/06/2012
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