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8291 N Booth Avenue Kansas City MO 64158 | |
| (816) 728-2979 | |
| (816) 415-3286 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 8291 N Booth Avenue, Kansas City, Missouri |
| Authorized Official Name and Position | Bryan K Watanabe (OWNER) |
| Authorized Official Contact | 8167282979 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
17000 Red Hill Ave Irvine CA 92614-5626 Ph: (714) 845-8890 | 8291 N Booth Avenue Kansas City MO 64158 Ph: (816) 728-2979 |
| NPI Number | 1780056135 |
|---|---|
| Provider Enumeration Date | 10/26/2015 |
| Last Update Date | 10/26/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780056135 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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