Organization
VILLAGE COMPLETE DENTISTRY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BLAIR EDGINGTON HANNAMAN DDS (MEMBER/DENTIST)
(913) 381-4700
Entity
Organization
Contact information
Practice address
4121 W 83RD ST STE 137, PRAIRIE VILLAGE, KS 66208-5323
(913) 381-4700
Mailing address
4121 W 83RD ST STE 137, PRAIRIE VILLAGE, KS 66208-5323
(913) 381-4700
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
05/06/2021
Last updated
05/06/2021
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