| Dr. Edward D. Dallam | |
|
4437 S River Blvd Independence MO 64055-4658 | |
| (816) 373-8800 | |
| (816) 373-2452 |
| Full Name | Dr. Edward D. Dallam |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 4437 S River Blvd, Independence, Missouri |
| Authorized Official Name and Position | Edward D. Dallam (OWNER) |
| Authorized Official Contact | 8163738800 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. Edward D. Dallam 4437 S River Blvd Independence MO 64055-4658 Ph: (816) 373-8800 | Dr. Edward D. Dallam 4437 S River Blvd Independence MO 64055-4658 Ph: (816) 373-8800 |
| NPI Number | 1346391695 |
|---|---|
| Provider Enumeration Date | 01/15/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346391695 | NPI | - | NPPES |
| 06778074 | Other | MO | BLUE CROSS BLUE SHEILD KC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | MO12689 (Missouri) | Primary |
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