Organization · Type 2 NPI
Independence Avenue Dental LLC
Dental Clinic/Center · Independence, MO
NPI number
1396982468
Active
Practice location
1638 West 24 Highway
Independence, MO 64050
Fax (816) 461-3675
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dental Clinic/Center Primary | 261QD0000X | None listed |
Dental Clinic/Center: Definition to come...
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About NPI 1396982468
Independence Avenue Dental LLC's National Provider Identifier is 1396982468, issued on Jan 12, 2009. The primary taxonomy on file is Dental Clinic/Center (261QD0000X), and the practice location is in Independence, MO. The record was last updated on Jun 11, 2020.