Individual
JENTRY JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Credential
DDS
Contact information
Practice address
3215 MAIN ST STE 100, KANSAS CITY, MO 64111-1926
(913) 850-3647
Mailing address
3215 MAIN ST STE 100, KANSAS CITY, MO 64111-1926
(913) 850-3647
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2025019819
MO
Other
Enumeration date
06/05/2025
Last updated
06/05/2025
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