Healthcare Provider Details

I. General information

NPI: 1841288974
Provider Name (Legal Business Name): CAROL J JONES-CRALL DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2005
Last Update Date: 06/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

707 MINNESOTA AVE SUITE 100
KANSAS CITY KS
66101-2516
US

IV. Provider business mailing address

707 MINNESOTA AVE SUITE 100
KANSAS CITY KS
66101-2516
US

V. Phone/Fax

Practice location:
  • Phone: 913-321-4385
  • Fax: 913-321-4037
Mailing address:
  • Phone: 913-321-4385
  • Fax: 913-321-4037

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number60337
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: