Organization
SUMMIT FAMILY DENTAL ARTS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY CALLOWAY DDS (MANAGER)
(816) 721-8334
Entity
Organization
Contact information
Practice address
1701 SW US HIGHWAY 40 STE 202, BLUE SPRINGS, MO 64015-4647
(816) 229-2442
Mailing address
4045 NE LAKEWOOD WAY STE 150, LEES SUMMIT, MO 64064-1997
(816) 350-9119
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1083900021
NPI
MO
01
—
1659829588
NPI
MO
Enumeration date
08/16/2021
Last updated
08/16/2021
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