Organization
FAMILY DENTAL CO, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MELISSA E KUSIAK DDS (OWNER)
(913) 269-2088
Entity
Organization
Contact information
Practice address
7311 W 79TH ST, OVERLAND PARK, KS 66204-2908
(913) 269-2088
Mailing address
7653 COLONIAL DR, PRAIRIE VILLAGE, KS 66208-4638
(913) 269-2088
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
60886
KS
Other
Enumeration date
08/19/2014
Last updated
10/22/2014
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