Organization
INDEPENDENCE PEDIATRIC DENTISTRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAYNA BAHR (MANAGER)
(816) 461-3661
Entity
Organization
Contact information
Practice address
651 E 24 HWY, INDEPENDENCE, MO 64050-2974
(816) 461-3661
(913) 210-2224
Mailing address
10975 GRANDVIEW DR STE 350, OVERLAND PARK, KS 66210-1522
(913) 210-2224
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
12/12/2017
Last updated
03/25/2026
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