Organization
CLAYCOMO DENTAL GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRYAN SHEWANICK D.D.S. (DENTIST)
(816) 454-1313
Entity
Organization
Contact information
Practice address
244 E US HIGHWAY 69, SUITE 101, KANSAS CITY, MO 64119-3184
(816) 454-1313
(816) 454-5377
Mailing address
244 E US HIGHWAY 69, SUITE 101, KANSAS CITY, MO 64119-3184
(816) 454-1313
(816) 454-5377
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
2009016386
MO
Other
Enumeration date
04/15/2014
Last updated
04/15/2014
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