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Individual

DR. CASSANDRA COLLINS MCKENZIE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MA, DDS, MS

Contact information

Practice address
13316 METCALF AVE, OVERLAND PARK, KS 66213-2804
(913) 851-5110
Mailing address
13316 METCALF AVE, OVERLAND PARK, KS 66213-2804
(913) 851-5110

Taxonomy

Speciality
Code
Description
License number
State
1223P0300X
Periodontics
2014021685
MO
1223P0300X
Periodontics
Primary
61312
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2014021685
DENTAL SPECIALIST - MISSOURI DENTAL BOARD
MO
01
61312
PERIODONTICS - KANSAS DENTAL BOARD
KS
Enumeration date
07/09/2014
Last updated
03/07/2023
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