Personal Care Dental Group LLC

NPI #1861576902 in Raytown, Missouri

Provider Information

NPI Number: 1861576902
Entity Type: Organization
Organization Name: Personal Care Dental Group LLC
Primary Specialty: Dentist - General Practice
Enumeration Date: Oct 25, 2006
Last Updated: Aug 22, 2020

Practice Location

Address: 9500 E 63RD STREET
Address 2: STE # 103
City: Raytown
State: Missouri
ZIP Code: 64133
Phone: (816) 737-1110

Authorized Official

Name: JENNIFER L JOHNSON
Title: CO OFFICE MANAGER
Phone: (816) 737-1110

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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