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NPI Code Detail

MEDICARE: DR. MARK KING DDS

MEDICARE: DR. MARK KING DDS
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
11223G0001XGeneral Practice Dentistry2003013101MO

General Provider Information

NPI Number : 1699702233
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARK KING DDS
Provider Business Mailing Address
First Line : 2816 E 23RD ST
Second Line :
City : KANSAS CITY
State : MO
Zip : 64127-4002
Country : US
Telephone Number : 816-231-3955
Fax Number :
Provider Business Practice Location Address
First Line : 2816 E 23RD ST
Second Line :
City : KANSAS CITY
State : MO
Zip : 64127-4002
Country : US
Telephone Number : 816-231-3955
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/27/2006
Last Update Date : 07/08/2007

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Directions to “ DR. MARK KING DDS” Practice Location

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