| South Independence Dental Llc | |
|
12400 E 40 Hwy Independence MO 64055-5929 | |
| (816) 897-5850 | |
| (816) 897-5851 |
| Full Name | South Independence Dental Llc |
|---|---|
| Speciality | Dentist |
| Location | 12400 E 40 Hwy, Independence, Missouri |
| Authorized Official Name and Position | Michael Lee (PARTNER) |
| Authorized Official Contact | 8168975850 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| South Independence Dental Llc 12400 E 40 Hwy Independence MO 64055-5929 Ph: (816) 897-5850 | South Independence Dental Llc 12400 E 40 Hwy Independence MO 64055-5929 Ph: (816) 897-5850 |
| NPI Number | 1245842202 |
|---|---|
| Provider Enumeration Date | 08/20/2020 |
| Last Update Date | 09/14/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245842202 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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