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Organization

JEREMY R. FRY, D.D.S., M.S., LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JEREMY R FRY D.D.S., M.S., LLC (OWNER)
(913) 469-9191
Entity
Organization

Contact information

Practice address
11940 QUIVIRA RD, OVERLAND PARK, KS 66213-2222
(913) 469-9191
(913) 469-6491
Mailing address
11940 QUIVIRA RD, OVERLAND PARK, KS 66213-2222
(913) 469-9191
(913) 469-6491

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
60358
KS

Other

Enumeration date
12/15/2011
Last updated
12/15/2011
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