Organization
PERIODONTAL CARE, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ANNE E PETERSON JD, CDFA, MS (BUSINESS MANAGER)
(913) 681-8100
Entity
Organization
Contact information
Practice address
5000 W 95TH ST STE 270, PRAIRIE VILLAGE, KS 66207-3300
(913) 341-4141
(913) 341-4432
Mailing address
5000 W 95TH ST STE 270, PRAIRIE VILLAGE, KS 66207-3300
(913) 341-4141
(913) 341-4432
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
2010016137
MO
Other
Enumeration date
07/14/2017
Last updated
03/17/2018
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