Organization
HAYWOOD L HAMBRICK, D.D.S. INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HAYWOOD LEE HAMBRICK D D S (OWNER)
(816) 523-7766
Entity
Organization
Contact information
Practice address
1115 EAST 65TH STREET, KANSAS CITY, MO 64131-1202
(816) 523-7766
(816) 523-2263
Mailing address
1115 E 65TH ST, KANSAS CITY, MO 64131-1202
(816) 523-7766
(816) 523-2263
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
012136 / 591
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2181
DORAL
MO
05
—
400750402
—
MO
01
—
609100
BRIDGEPORT
MO
Enumeration date
04/23/2008
Last updated
04/23/2008
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