Organization
STATE AVENUE DENTAL LLC
Active
Other names
Comfort Dental - State Avenue
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW FOGG TINGEY DDS (DENTIST)
(913) 213-6973
Entity
Organization
Contact information
Practice address
7933 STATE AVE, SUITE 101, KANSAS CITY, KS 66112-2468
(913) 213-6973
(913) 213-6972
Mailing address
7933 STATE AVE, SUITE 101, KANSAS CITY, KS 66112-2468
(913) 213-6973
(913) 213-6972
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
60853
KS
Other
Enumeration date
07/11/2012
Last updated
07/11/2012
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