Organization
PEDS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW DAVID ANDERSON D.D.S. (ORGANIZER)
(402) 972-7751
Entity
Organization
Contact information
Practice address
4741 CENTRAL ST, SUITE #107, KANSAS CITY, MO 64112-1533
(402) 972-7751
Mailing address
4741 CENTRAL ST, SUITE #107, KANSAS CITY, MO 64112-1533
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
2014012737
MO
Other
Enumeration date
08/18/2014
Last updated
08/18/2014
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