| Personal Care Dental Group Llc | |
|
9500 E 63rd Street Ste # 103 Raytown MO 64133 | |
| (816) 737-1110 | |
| (816) 356-9005 |
| Full Name | Personal Care Dental Group Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 9500 E 63rd Street, Raytown, Missouri |
| Authorized Official Name and Position | Jennifer L Johnson (CO OFFICE MANAGER) |
| Authorized Official Contact | 8167371110 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Personal Care Dental Group Llc 9500 E 63rd Street Ste # 103 Raytown MO 64133 Ph: (816) 737-1110 | Personal Care Dental Group Llc 9500 E 63rd Street Ste # 103 Raytown MO 64133 Ph: (816) 737-1110 |
| NPI Number | 1861576902 |
|---|---|
| Provider Enumeration Date | 10/25/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861576902 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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