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General NPI Number Information
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NPI Number | 1326783408
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Entity Type | Organization
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Legal Business Name | KELLY H TOOMBS, DDS, PA
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Dates
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Enumeration Date | 05/03/2022
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Last Update Date | 05/03/2022
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Provider Practice Location Address
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Address Line | 3700 W 83RD ST STE 2215
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City | PRAIRIE VILLAGE
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State | KS
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Zip | 66208-5120
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Country | US
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Telephone | 913-381-5292
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Fax |
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Provider Business Mailing Address
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Address Line | 3700 W 83RD ST STE 2215
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City | PRAIRIE VILLAGE
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State | KS
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Zip | 66208-5120
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Country | US
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Telephone | 913-381-5292
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Fax |
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Authorized Official
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Title or Position | LEAD OF CREDENTIALING
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Name | VICENTA REYES
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Credential |
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Telephone | 972-869-3789
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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