| KC Cone Beam, L.L.C. | |
|
11900 W 87th Street Pkwy Suite 128 Lenexa KS 66215-2807 | |
| (913) 599-2228 | |
| (913) 599-2229 |
| Full Name | KC Cone Beam, L.L.C. |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Radiology |
| Location | 11900 W 87th Street Pkwy, Lenexa, Kansas |
| Authorized Official Name and Position | Kevin P. Cunningham (OWNER) |
| Authorized Official Contact | 9135992228 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| KC Cone Beam, L.L.C. 11900 W 87th Street Pkwy Suite 128 Lenexa KS 66215-2807 Ph: (913) 599-2228 | KC Cone Beam, L.L.C. 11900 W 87th Street Pkwy Suite 128 Lenexa KS 66215-2807 Ph: (913) 599-2228 |
| NPI Number | 1073928495 |
|---|---|
| Provider Enumeration Date | 06/24/2014 |
| Last Update Date | 06/24/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073928495 | NPI | - | NPPES |
| BL13-00155 | Other | KS | LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0008X | Dentist - Oral And Maxillofacial Radiology | BL13-00155 (Kansas) | Primary |
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