MEDICARE: CHRISTOPHER F WICK, DDS & MICHAEL C JOURNEE, DDS, PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	2004015365	MO

General Provider Information

NPI Number	:	1538401237
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHRISTOPHER F WICK, DDS & MICHAEL C JOURNEE, DDS, PC

Provider Business Mailing Address
First Line	:	4910 NE 81ST ST
Second Line	:	SUITE A
City	:	KANSAS CITY
State	:	MO
Zip	:	64119-8400
Country	:	US
Telephone Number	:	816-420-9070
Fax Number	:	816-420-9052

Provider Business Practice Location Address
First Line	:	4910 NE 81ST ST
Second Line	:	SUITE A
City	:	KANSAS CITY
State	:	MO
Zip	:	64119-8400
Country	:	US
Telephone Number	:	816-420-9070
Fax Number	:	816-420-9052

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. CHRISTOPHER F WICK
Credential	:	DDS
Telephone Number	:	816-420-9070

Provider Enumeration Date	:	03/20/2013
Last Update Date	:	03/20/2013

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