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General NPI Number Information
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NPI Number | 1407582828
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Entity Type | Organization
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Legal Business Name | TWIN CREEKS FD, LLC
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Dates
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Enumeration Date | 07/27/2022
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Last Update Date | 11/02/2023
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Provider Practice Location Address
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Address Line | 10560 N AMBASSADOR DR STE 200
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City | KANSAS CITY
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State | MO
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Zip | 64153-1591
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Country | US
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Telephone | 816-891-8091
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Fax |
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Provider Business Mailing Address
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Address Line | 4329 NW BRIARCLIFF LN
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City | KANSAS CITY
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State | MO
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Zip | 64116-1607
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Country | US
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Telephone | 913-707-5445
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. ANISHA PATEL
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Credential | DDS
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Telephone | 913-707-5445
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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