Organization
RAYTOWN DENTAL
Active
Other names
Comfort Dental Raytown
Organization subpart
No
Provider details
NPI number
Authorized official
DWIGHT TIMOTHY JOHNSON DDS (DENTIST)
(816) 837-4010
Entity
Organization
Contact information
Practice address
8600 E 63RD ST, RAYTOWN, MO 64133
(816) 837-4010
(816) 837-4011
Mailing address
8600 E 63RD ST, RAYTOWN, MO 64133
(816) 837-4010
(816) 837-4011
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
400060672
—
MO
Enumeration date
10/25/2021
Last updated
10/25/2021
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