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NPI Code Detail

MEDICARE: MIDTOWN DENTAL LLC

MEDICARE: MIDTOWN DENTAL LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist

General Provider Information

NPI Number : 1306428362
Entity Type Code : Organization
Provider Name (Legal Business Name) : MIDTOWN DENTAL LLC
Provider Business Mailing Address
First Line : 106 E 30TH ST
Second Line :
City : KANSAS CITY
State : MO
Zip : 64108-3211
Country : US
Telephone Number : 816-643-3400
Fax Number :
Provider Business Practice Location Address
First Line : 3215 MAIN ST STE 100A
Second Line :
City : KANSAS CITY
State : MO
Zip : 64111-1946
Country : US
Telephone Number : 402-580-2674
Fax Number :
Authorized Official
Title or Position : DENTIST
Name : DR. DANIEL NGUYEN
Credential : DDS
Telephone Number : 402-580-2764
Provider Enumeration Date : 04/28/2021
Last Update Date : 04/28/2021

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Directions to “MIDTOWN DENTAL LLC ” Practice Location

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