| Shoal Valley Dental | |
|
4910 Ne 81st St Suite A Kansas City MO 64119-8400 | |
| (816) 420-9070 | |
| (816) 420-9052 |
| Full Name | Shoal Valley Dental |
|---|---|
| Speciality | Dentist |
| Location | 4910 Ne 81st St, Kansas City, Missouri |
| Authorized Official Name and Position | Christopher F Wick (PRESIDENT) |
| Authorized Official Contact | 8164209070 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shoal Valley Dental 4910 Ne 81st St Suite A Kansas City MO 64119-8400 Ph: (816) 420-9070 | Shoal Valley Dental 4910 Ne 81st St Suite A Kansas City MO 64119-8400 Ph: (816) 420-9070 |
| NPI Number | 1538401237 |
|---|---|
| Provider Enumeration Date | 03/20/2013 |
| Last Update Date | 03/20/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538401237 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 2004015365 (Missouri) | Primary |
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