| Pediatric Dental Specialists, Pa | |
| 3355 Ne Ralph Powell Road Lee's Summit MO 64064 | |
| (816) 525-5447 | |
| Not Available | 
| Full Name | Pediatric Dental Specialists, Pa | 
|---|---|
| Speciality | Clinic/center - Dental | 
| Location | 3355 Ne Ralph Powell Road, Lee's Summit, Missouri | 
| Authorized Official Name and Position | Donna K. Thomas (OWNER) | 
| Authorized Official Contact | 8165255447 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Pediatric Dental Specialists, Pa 3355 Ne Ralph Powell Road Lee's Summit MO 64064 Ph: (816) 525-5447 | Pediatric Dental Specialists, Pa 3355 Ne Ralph Powell Road Lee's Summit MO 64064 Ph: (816) 525-5447 | 
| NPI Number | 1811011018 | 
|---|---|
| Provider Enumeration Date | 03/16/2007 | 
| Last Update Date | 03/10/2008 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1811011018 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 015672 (Missouri) | Primary |