| Claycomo Dental Group Llc | |
|
244 E Us Highway 69 Suite 101 Kansas City MO 64119-3184 | |
| (816) 454-1313 | |
| (816) 454-5377 |
| Full Name | Claycomo Dental Group Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 244 E Us Highway 69, Kansas City, Missouri |
| Authorized Official Name and Position | Bryan Shewanick (DENTIST) |
| Authorized Official Contact | 8164541313 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Claycomo Dental Group Llc 244 E Us Highway 69 Suite 101 Kansas City MO 64119-3184 Ph: (816) 454-1313 | Claycomo Dental Group Llc 244 E Us Highway 69 Suite 101 Kansas City MO 64119-3184 Ph: (816) 454-1313 |
| NPI Number | 1205255460 |
|---|---|
| Provider Enumeration Date | 04/15/2014 |
| Last Update Date | 04/15/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205255460 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 2009016386 (Missouri) | Primary |
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