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319 Ne Vivion Rd Kansas City MO 64118-4510 | |
| (210) 451-0000 | |
| (210) 233-8829 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 319 Ne Vivion Rd, Kansas City, Missouri |
| Authorized Official Name and Position | David B Ferguson (OWNER) |
| Authorized Official Contact | 2104510000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
319 Ne Vivion Rd Kansas City MO 64118-4510 Ph: (210) 451-0000 | 319 Ne Vivion Rd Kansas City MO 64118-4510 Ph: (210) 451-0000 |
| NPI Number | 1003361791 |
|---|---|
| Provider Enumeration Date | 08/23/2016 |
| Last Update Date | 01/09/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003361791 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 2008028696 (Missouri) | Primary |
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