Organization
GRACE DENTAL, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL DANLEY RDH (GENERAL MANAGER)
(913) 685-9111
Entity
Organization
Contact information
Practice address
12611 ANTIOCH RD, OVERLAND PARK, KS 66213
(913) 685-9111
(913) 685-8486
Mailing address
12611 ANTIOCH RD, OVERLAND PARK, KS 66213
(913) 685-9111
(913) 685-8486
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6166
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13970060
BCBS
KS
01
—
808110
UNITED CONCORDIA
KS
Enumeration date
03/16/2007
Last updated
08/22/2020
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