| Eastland Family Dental, Llc | |
|
19401 E 40 Hwy Suite 180 Independence MO 64055-5450 | |
| (816) 795-7007 | |
| (816) 795-7073 |
| Full Name | Eastland Family Dental, Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 19401 E 40 Hwy, Independence, Missouri |
| Authorized Official Name and Position | James Eric Moore (OWNER) |
| Authorized Official Contact | 8167957007 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Eastland Family Dental, Llc 19401 E 40 Hwy Suite 180 Independence MO 64055-5450 Ph: (816) 795-7007 | Eastland Family Dental, Llc 19401 E 40 Hwy Suite 180 Independence MO 64055-5450 Ph: (816) 795-7007 |
| NPI Number | 1730401738 |
|---|---|
| Provider Enumeration Date | 02/18/2010 |
| Last Update Date | 02/18/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730401738 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 2003011849 (Missouri) | Primary |
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