Organization
KC DENTAL CO LLC
Active
Other names
Mill Creek Dental
Organization subpart
No
Provider details
NPI number
Authorized official
MCKENZIE LEWIS (GENERAL MANAGER)
(816) 347-9933
Entity
Organization
Contact information
Practice address
3555 NE RALPH POWELL RD, LEES SUMMIT, MO 64064-2360
(816) 347-9933
Mailing address
3555 NE RALPH POWELL RD, LEES SUMMIT, MO 64064-2360
(816) 347-9933
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
04/17/2025
Last updated
04/17/2025
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