| Johnson County Periodontics Dental Implants & Laser Surgery | |
|
4601 W. 109th St. Suite 212 Overland Park KS 66211 | |
| (913) 491-5548 | |
| (913) 491-0793 |
| Full Name | Johnson County Periodontics Dental Implants & Laser Surgery |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 4601 W. 109th St., Overland Park, Kansas |
| Authorized Official Name and Position | Lara L Tull Ryan (OWNER) |
| Authorized Official Contact | 9134915548 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Johnson County Periodontics Dental Implants & Laser Surgery 4601 W 109th St Suite 212 Overland Park KS 66211 Ph: (913) 491-5548 | Johnson County Periodontics Dental Implants & Laser Surgery 4601 W. 109th St. Suite 212 Overland Park KS 66211 Ph: (913) 491-5548 |
| NPI Number | 1013904564 |
|---|---|
| Provider Enumeration Date | 09/30/2005 |
| Last Update Date | 04/27/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013904564 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | 60284 (Kansas) | Primary |
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