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General NPI Number Information
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NPI Number | 1689399651
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Entity Type | Organization
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Legal Business Name | RACHEL BRUNKER DDS LLC
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Dates
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Enumeration Date | 10/11/2022
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Last Update Date | 10/11/2022
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Provider Practice Location Address
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Address Line | 209 NW BLUE PKWY
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City | LEES SUMMIT
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State | MO
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Zip | 64063-1872
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Country | US
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Telephone | 816-529-9090
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Fax | 816-246-0311
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Provider Business Mailing Address
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Address Line | 209 NW BLUE PKWY
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City | LEES SUMMIT
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State | MO
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Zip | 64063-1872
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Country | US
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Telephone | 816-529-9090
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Fax | 816-246-0311
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Authorized Official
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Title or Position | DENTIST/OWNER
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Name | RACHEL BRUNKER
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Credential | DDS
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Telephone | 816-529-9090
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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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