Organization
VILLAGE DENTAL GLADSTONE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NELSON KANNING DDS (OWNER)
(913) 515-3359
Entity
Organization
Contact information
Practice address
4104 NE VIVION RD, KANSAS CITY, MO 64119-2811
(816) 452-8700
Mailing address
4104 NE VIVION RD, KANSAS CITY, MO 64119-2811
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
01/03/2024
Last updated
01/03/2024
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