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Organization

ABC DENTAL LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KRISTA SHEHAN (OFFICE MANAGER)
(816) 461-0055
Entity
Organization

Contact information

Practice address
1619 W US HIGHWAY 24, INDEPENDENCE, MO 64050-2345
(816) 461-0055
(816) 461-0068
Mailing address
1619 W US HIGHWAY 24, INDEPENDENCE, MO 64050-2345
(816) 461-0055
(816) 461-0068

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary

Other

Enumeration date
10/15/2010
Last updated
12/30/2011
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