Organization
ETHERIDGE COMPLETE DENTISTRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANA CHRISTIAN (OFFICE MANAGER)
(816) 525-1655
Entity
Organization
Contact information
Practice address
818 NW PARK LN, LEES SUMMIT, MO 64063-1880
(816) 525-1655
(816) 524-7800
Mailing address
818 NW PARK LN, LEES SUMMIT, MO 64063-1880
(816) 525-1655
(816) 524-7800
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
12/18/2018
Last updated
12/18/2018
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