| Haywood L Hambrick, D.d.s. Inc | |
|
1115 East 65th Street Kansas City MO 64131-1202 | |
| (816) 523-7766 | |
| (816) 523-2263 |
| Full Name | Haywood L Hambrick, D.d.s. Inc |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 1115 East 65th Street, Kansas City, Missouri |
| Authorized Official Name and Position | Haywood Lee Hambrick (OWNER) |
| Authorized Official Contact | 8165237766 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Haywood L Hambrick, D.d.s. Inc 1115 E 65th St Kansas City MO 64131-1202 Ph: (816) 523-7766 | Haywood L Hambrick, D.d.s. Inc 1115 East 65th Street Kansas City MO 64131-1202 Ph: (816) 523-7766 |
| NPI Number | 1790950582 |
|---|---|
| Provider Enumeration Date | 04/23/2008 |
| Last Update Date | 04/23/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790950582 | NPI | - | NPPES |
| 2181 | Other | MO | DORAL |
| 609100 | Other | MO | BRIDGEPORT |
| 400750402 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 012136 / 591 (Missouri) | Primary |
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