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General NPI Number Information
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NPI Number | 1326193392
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Entity Type | Organization
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Legal Business Name | NORTH KANSAS CITY FAMILY AND COSMETIC DENTAL CARE LLC
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Dates
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Enumeration Date | 01/23/2007
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Last Update Date | 01/17/2008
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Provider Practice Location Address
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Address Line | 101 E 23RD AVE
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City | NORTH KANSAS CITY
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State | MO
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Zip | 64116-3010
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Country | US
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Telephone | 816-221-2153
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Fax | 816-221-2154
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Provider Business Mailing Address
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Address Line | 101 E 23RD AVE
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City | NORTH KANSAS CITY
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State | MO
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Zip | 64116-3010
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Country | US
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Telephone | 816-221-2153
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Fax | 816-221-2154
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Authorized Official
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Title or Position | DENTIST
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Name | DR. WILLIAM BROWN JR.
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Credential | DDS
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Telephone | 816-221-2153
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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