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General NPI Number Information
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NPI Number | 1649302019
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Entity Type | Organization
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Legal Business Name | WILLIAM T. KANE, DDS,MBA,PL
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Dates
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Enumeration Date | 03/12/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 913 WEST BUSINESS HIGHWAY 60
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City | DEXTER
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State | MO
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Zip | 63841
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Country | US
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Telephone | 573-624-7456
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Fax | 573-624-5182
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Provider Business Mailing Address
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Address Line | POST OFFICE BOX 246 913 WEST BUSINESS HIGHWAY 60
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City | DEXTER
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State | MO
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Zip | 63841
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Country | US
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Telephone | 573-624-7456
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Fax | 573-624-5182
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Authorized Official
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Title or Position | OWNER PRACTITIONER
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Name | DR. WILLIAM T KANE
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Credential | DDS MBA
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Telephone | 573-624-7456
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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 | 13323
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License Number State | MO
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