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General NPI Number Information
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NPI Number | 1538401237
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Entity Type | Organization
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Legal Business Name | CHRISTOPHER F WICK, DDS & MICHAEL C JOURNEE, DDS, PC
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Dates
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Enumeration Date | 03/20/2013
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Last Update Date | 03/20/2013
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Provider Practice Location Address
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Address Line | 4910 NE 81ST ST SUITE A
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City | KANSAS CITY
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State | MO
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Zip | 64119-8400
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Country | US
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Telephone | 816-420-9070
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Fax | 816-420-9052
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Provider Business Mailing Address
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Address Line | 4910 NE 81ST ST SUITE A
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City | KANSAS CITY
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State | MO
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Zip | 64119-8400
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Country | US
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Telephone | 816-420-9070
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Fax | 816-420-9052
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CHRISTOPHER F WICK
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Credential | DDS
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Telephone | 816-420-9070
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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 | 2004015365
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License Number State | MO
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