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NPI Code Detail

MEDICARE: HUCKABEE & HUCKABEE DDS

MEDICARE: HUCKABEE & HUCKABEE 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 Dentistry015721MO

General Provider Information

NPI Number : 1932322245
Entity Type Code : Organization
Provider Name (Legal Business Name) : HUCKABEE & HUCKABEE DDS
Provider Business Mailing Address
First Line : 4701 LOGAN AVE
Second Line :
City : KANSAS CITY
State : MO
Zip : 64136-1161
Country : US
Telephone Number : 816-350-1007
Fax Number : 816-350-1975
Provider Business Practice Location Address
First Line : 4701 LOGAN AVE
Second Line :
City : KANSAS CITY
State : MO
Zip : 64136-1161
Country : US
Telephone Number : 816-350-1007
Fax Number : 816-350-1975
Authorized Official
Title or Position : PRESIDENT
Name : DR. SAMUEL J HUCKABEE
Credential : D.D.S.
Telephone Number : 816-350-1007
Provider Enumeration Date : 04/11/2007
Last Update Date : 08/22/2020

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Directions to “HUCKABEE & HUCKABEE DDS ” Practice Location

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