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NPI Code Detail

MEDICARE: DR. AMY LURAE WESTERBERG DDS

MEDICARE: DR. AMY LURAE WESTERBERG DDS
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
11223G0001XGeneral Practice Dentistry2017023184MO

General Provider Information

NPI Number : 1760904536
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. AMY LURAE WESTERBERG DDS
Provider Business Mailing Address
First Line : 4546 MAIN ST
Second Line :
City : KANSAS CITY
State : MO
Zip : 64111-1816
Country : US
Telephone Number : 816-931-2342
Fax Number :
Provider Business Practice Location Address
First Line : 4546 MAIN ST
Second Line :
City : KANSAS CITY
State : MO
Zip : 64111-1816
Country : US
Telephone Number : 816-931-2342
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/12/2017
Last Update Date : 07/21/2022

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