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General NPI Number Information
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NPI Number | 1588522163
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Entity Type | Organization
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Legal Business Name | FOHDC LLC
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Dates
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Enumeration Date | 01/13/2026
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Last Update Date | 01/13/2026
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Provider Practice Location Address
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Address Line | 3815 BECK ROAD SAINT JO
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City | SAINT JOSEPH
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State | MO
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Zip | 64506-4941
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Country | US
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Telephone | 816-233-0142
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Fax |
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Provider Business Mailing Address
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Address Line | 3815 BECK ROAD
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City | SAINT JOSEPH
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State | MO
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Zip | 64506-4941
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Country | US
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Telephone | 816-233-0142
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Fax |
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Authorized Official
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Title or Position | PARTNER
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Name | SUSAN C CHARLES
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Credential | DDS
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Telephone | 816-233-0142
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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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