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General NPI Number Information
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NPI Number | 1366179707
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Entity Type | Organization
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Legal Business Name | VALUDENTAL ROELAND PARK LLC
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Dates
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Enumeration Date | 08/05/2022
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Last Update Date | 01/13/2023
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Provider Practice Location Address
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Address Line | 4980 ROE BLVD STE A
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City | ROELAND PARK
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State | KS
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Zip | 66205-1110
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Country | US
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Telephone | 913-355-0000
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Fax |
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Provider Business Mailing Address
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Address Line | 319 NE VIVION RD
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City | KANSAS CITY
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State | MO
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Zip | 64118-4510
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Country | US
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Telephone | 816-459-0000
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Fax | 816-293-9193
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | LINDA ESLER
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Credential |
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Telephone | 913-355-0000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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