Independence Pediatric Dentistry LLC
NPI #1376058420 in Independence, Missouri
Provider Information
- NPI Number
- 1376058420
- Entity Type
- Organization
- Organization Name
- Independence Pediatric Dentistry LLC
- Primary Specialty
- Dentist - Pediatric Dentistry
- Enumeration Date
- Dec 12, 2017
- Last Updated
- Dec 12, 2017
Practice Location
- Address
- 651 E 24 HWY
- City
- Independence
- State
- Missouri
- ZIP Code
- 64050-2974
- Phone
- (816) 461-3661
Authorized Official
- Name
- SHAYNA BAHR
- Title
- MANAGER
- Phone
- (816) 461-3661
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - Pediatric Dentistry — Pediatric Dentistry |
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