Organization
PERSONAL CARE DENTAL GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER L JOHNSON (CO OFFICE MANAGER)
(816) 737-1110
Entity
Organization
Contact information
Practice address
9500 E 63RD STREET, STE # 103, RAYTOWN, MO 64133
(816) 737-1110
(816) 356-9005
Mailing address
9500 E 63RD STREET, STE # 103, RAYTOWN, MO 64133
(816) 737-1110
(816) 356-9005
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
10/25/2006
Last updated
08/22/2020
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