Individual
MR. CHRISTOPHER FREDOLIN WICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4910A NE 81ST ST, KANSAS CITY, MO 64119-8400
(816) 420-9070
(816) 420-9052
Mailing address
19323 W 63RD TERRACE, SHAWNEE, KS 66218
(913) 269-5142
(816) 420-9052
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2004015365
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
407174200
—
MO
Enumeration date
12/27/2005
Last updated
11/01/2011
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