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801 W 47th St Suite 408 Kansas City MO 64112-1377 | |
| (816) 561-6150 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 801 W 47th St, Kansas City, Missouri |
| Authorized Official Name and Position | Dustin K Mace (OWNER) |
| Authorized Official Contact | 8165616150 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
801 W 47th St Suite 408 Kansas City MO 64112-1377 Ph: (816) 561-6150 | 801 W 47th St Suite 408 Kansas City MO 64112-1377 Ph: (816) 561-6150 |
| NPI Number | 1316289424 |
|---|---|
| Provider Enumeration Date | 03/27/2013 |
| Last Update Date | 03/27/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316289424 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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