| Comfort Dental Raytown | |
|
8600 E 63rd St Raytown MO 64133 | |
| (816) 837-4010 | |
| (816) 837-4011 |
| Full Name | Comfort Dental Raytown |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 8600 E 63rd St, Raytown, Missouri |
| Authorized Official Name and Position | Dwight Timothy Johnson (DENTIST) |
| Authorized Official Contact | 8168374010 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Comfort Dental Raytown 8600 E 63rd St Raytown MO 64133 Ph: (816) 837-4010 | Comfort Dental Raytown 8600 E 63rd St Raytown MO 64133 Ph: (816) 837-4010 |
| NPI Number | 1972267284 |
|---|---|
| Provider Enumeration Date | 10/25/2021 |
| Last Update Date | 10/25/2021 |
| Certification Date | 10/06/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972267284 | NPI | - | NPPES |
| 400060672 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | () | Primary |
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