Organization
SMILE SAFARI OF MISSOURI
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BONNIE BRIZENDINE (DIRECTOR OF OPERATIONS)
(614) 563-8681
Entity
Organization
Contact information
Practice address
10016 E 63RD ST, RAYTOWN, MO 64133-5102
(816) 313-8485
Mailing address
1709 S MUR LEN RD, OLATHE, KS 66062-2611
(913) 353-4001
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
04/11/2019
Last updated
04/11/2019
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