Organization
RM DENTAL GROUP EAST
Active
Other names
Grain Valley Family Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PETER BENJAMIN MCCLELLAN DDS (OWNER DENTIST)
(573) 230-6862
Entity
Organization
Contact information
Practice address
4516 BROADWAY, UNIT 301, KANSAS CITY, MO 64111-3381
(573) 230-6862
Mailing address
655 R D MIZE RD., GRAIN VALLEY, MO 64029
(816) 229-4560
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2010016286
MO
Other
Enumeration date
01/20/2017
Last updated
01/20/2017
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