Organization
SUMMIT VILLAGE FAMILY DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRYAN PACE (BUSINESS MANAGER)
(816) 525-5414
Entity
Organization
Contact information
Practice address
600 NW MURRAY RD, SUITE 304, LEES SUMMIT, MO 64081-1204
(816) 525-5414
Mailing address
600 NW MURRAY RD, SUITE 304, LEES SUMMIT, MO 64081-1204
(816) 525-5414
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
015384
MO
Other
Enumeration date
02/17/2016
Last updated
02/17/2016
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