Raytown Dental

NPI #1972267284 in Raytown, Missouri

Provider Information

NPI Number: 1972267284
Entity Type: Organization
Organization Name: Raytown Dental
Primary Specialty: Clinic/Center - Dental
Enumeration Date: Oct 25, 2021
Last Updated: Oct 25, 2021

Practice Location

Address: 8600 E 63RD ST
City: Raytown
State: Missouri
ZIP Code: 64133
Phone: (816) 837-4010

Authorized Official

Name: DWIGHT TIMOTHY JOHNSON, DDS
Title: DENTIST
Phone: (816) 837-4010

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Dental — Dental	261QD0000X	Primary

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