Individual
CLARK CHRISTOPHER CHANEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4121 W 83RD ST STE 206, PRAIRIE VILLAGE, KS 66208-5323
(913) 381-2828
Mailing address
5247 ROE BLVD, ROELAND PARK, KS 66205-2374
(913) 515-1561
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
61082
KS
Other
Enumeration date
08/05/2013
Last updated
12/17/2018
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