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1010 Carondelet Dr. Suite 316 Kansas City MO 64114 | |
| (816) 941-0000 | |
| (816) 941-3146 |
| Full Name | |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 1010 Carondelet Dr., Kansas City, Missouri |
| Authorized Official Name and Position | Robert L Ennis (PRESIDENT) |
| Authorized Official Contact | 8162542345 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1010 Carondelet Dr. Suite 316 Kansas City MO 64114 Ph: (816) 941-0000 | 1010 Carondelet Dr. Suite 316 Kansas City MO 64114 Ph: (816) 941-0000 |
| NPI Number | 1003917865 |
|---|---|
| Provider Enumeration Date | 09/26/2006 |
| Last Update Date | 07/25/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003917865 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
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