Individual
DR. KYONG A KONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
825 EUCLID AVE, KANSAS CITY, MO 64124-2323
(816) 474-4920
(816) 889-1845
Mailing address
825 EUCLID AVE, KANSAS CITY, MO 64124-2323
(816) 474-4920
(816) 889-1845
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2004000867
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
409037009
—
MO
01
—
C16000075
MEDICARE PTAN
MO
Enumeration date
07/30/2006
Last updated
10/12/2016
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