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General NPI Number Information
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NPI Number | 1659974855
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Entity Type | Organization
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Legal Business Name | SERENITY DENTAL
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Dates
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Enumeration Date | 11/19/2020
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Last Update Date | 11/19/2020
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Provider Practice Location Address
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Address Line | 1203 W HAROLD ST
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City | OLATHE
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State | KS
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Zip | 66061-7851
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Country | US
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Telephone | 913-229-4519
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Fax |
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Provider Business Mailing Address
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Address Line | 1203 W HAROLD ST
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City | OLATHE
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State | KS
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Zip | 66061-7851
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Country | US
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Telephone | 913-229-4519
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Fax |
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Authorized Official
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Title or Position | DR.
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Name | DR. MICHAEL A SILVA
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Credential | DDS
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Telephone | 191-363-4520
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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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