The Indian Springs Dental Clinic, LLC
NPI #1144207705 in Kansas City, Kansas
Provider Information
- NPI Number
- 1144207705
- Entity Type
- Organization
- Organization Name
- The Indian Springs Dental Clinic, LLC
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Dec 26, 2005
- Last Updated
- Mar 26, 2015
Practice Location
- Address
- 4655 STATE AVE
- City
- Kansas City
- State
- Kansas
- ZIP Code
- 66102-3603
- Phone
- (913) 287-7977
Authorized Official
- Name
- MRS. JENELL STUMP
- Title
- DIRECTOR, LICENSING & CREDENTIALING
- Phone
- (913) 287-7977
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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