Organization
KC DENTAL PROFESSIONALS, PA
Active
Parent organization
KC DENTAL PROFESSIONALS, PA
Other names
Deer Creek Family Dental Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
KC DENTAL PROFESSIONALS, PA
Authorized official
KIM WILSON (INSURANCE/CREDENTIALING)
(217) 540-5100
Entity
Organization
Contact information
Practice address
13328 METCALF AVE, OVERLAND PARK, KS 66213-2804
(913) 345-2273
(913) 345-8102
Mailing address
13328 METCALF AVE, OVERLAND PARK, KS 66213-2804
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
05/22/2009
Last updated
11/13/2012
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