South Independence Dental LLC
NPI #1245842202 in Independence, Missouri
Provider Information
- NPI Number
- 1245842202
- Entity Type
- Organization
- Organization Name
- South Independence Dental LLC
- Primary Specialty
- Dentist
- Enumeration Date
- Aug 20, 2020
- Last Updated
- Sep 14, 2020
Practice Location
- Address
- 12400 E 40 HWY
- City
- Independence
- State
- Missouri
- ZIP Code
- 64055-5929
- Phone
- (816) 897-5850
Authorized Official
- Name
- DR. MICHAEL LEE, DDS
- Title
- PARTNER
- Phone
- (816) 897-5850
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist |
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