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General NPI Number Information
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NPI Number | 1740793181
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Entity Type | Organization
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Legal Business Name | DANIEL BOCK DDS, LLC
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Dates
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Enumeration Date | 11/07/2017
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 4121 W 83RD ST STE 200
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City | PRAIRIE VILLAGE
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State | KS
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Zip | 66208-5323
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Country | US
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Telephone | 913-927-5466
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Fax |
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Provider Business Mailing Address
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Address Line | 7305 ASH ST
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City | PRAIRIE VILLAGE
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State | KS
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Zip | 66208-2441
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Country | US
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Telephone | 913-927-5466
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Fax |
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Authorized Official
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Title or Position | DENTIST/OWNER
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Name | DANIEL BOCK
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Credential | DDS
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Telephone | 913-385-2324
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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 | 60703
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License Number State | KS
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