Grain Valley Family Dental | |
4516 Broadway Unit 301 Kansas City MO 64111-3381 | |
(573) 230-6862 | |
Not Available |
Full Name | Grain Valley Family Dental |
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Speciality | Dentist |
Location | 4516 Broadway, Kansas City, Missouri |
Authorized Official Name and Position | Peter Benjamin Mcclellan (OWNER DENTIST) |
Authorized Official Contact | 5732306862 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Grain Valley Family Dental 655 R D Mize Rd. Grain Valley MO 64029 Ph: (816) 229-4560 | Grain Valley Family Dental 4516 Broadway Unit 301 Kansas City MO 64111-3381 Ph: (573) 230-6862 |
NPI Number | 1972040699 |
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Provider Enumeration Date | 01/20/2017 |
Last Update Date | 01/20/2017 |
Identifier | Type | State | Issuer |
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1972040699 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | 2010016286 (Missouri) | Primary |
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