Organization
BLUE VALLEY PEDIATRIC DENTISTRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VANESSA RENEE AXELSEN DDS (OWNER)
(913) 232-2708
Entity
Organization
Contact information
Practice address
7560 W 160TH ST, OVERLAND PARK, KS 66085
(913) 232-2708
(913) 232-2718
Mailing address
7560 W 160TH STREET, OVERLAND PARK, KS 66085
(913) 232-2708
(503) 232-2718
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
719
KS
Other
Enumeration date
06/22/2018
Last updated
10/18/2022
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