Organization
KANSAS CITY FACIAL AND ORAL SURGERY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN HOLLABAUGH MD, DDS (ORAL AND MAXILLOFACIAL SURGEON)
(816) 598-8166
Entity
Organization
Contact information
Practice address
2931 NE INDEPENDENCE AVE., LEES SUMMIT, MO 64064-6406
(816) 598-8166
Mailing address
117 SW SHORES DR, LEES SUMMIT, MO 64064-4502
(816) 510-5689
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
06/26/2020
Last updated
06/26/2020
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