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19709 W 97th St Lenexa KS 66220-3350 | |
| (913) 742-3654 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 19709 W 97th St, Lenexa, Kansas |
| Authorized Official Name and Position | Monica Long (COO) |
| Authorized Official Contact | 9137423654 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
19709 W 97th St Lenexa KS 66220-3350 Ph: () - | 19709 W 97th St Lenexa KS 66220-3350 Ph: (913) 742-3654 |
| NPI Number | 1780394791 |
|---|---|
| Provider Enumeration Date | 11/30/2022 |
| Last Update Date | 05/07/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780394791 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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