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General NPI Number Information
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NPI Number | 1760349757
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Entity Type | Organization
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Legal Business Name | KC CHILDRENS SURGERY CENTER LLC
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Dates
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Enumeration Date | 01/09/2026
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Last Update Date | 01/09/2026
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Provider Practice Location Address
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Address Line | 7848 STATE AVE
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City | KANSAS CITY
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State | KS
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Zip | 66112-2417
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Country | US
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Telephone | 443-228-3062
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Fax | 717-996-3128
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Provider Business Mailing Address
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Address Line | 31024 LORINE ST
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City | DELAND
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State | FL
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Zip | 32720-5675
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Country | US
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Telephone | 443-228-3062
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Fax | 717-996-3128
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Authorized Official
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Title or Position | AUTH SUPERVISOR
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Name | JENNIFER CONRAD
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Credential |
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Telephone | 443-228-3062
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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