Provider Demographics
NPI:1154484301
Name:THE ENDODONTIC P.C.
Entity Type:Organization
Organization Name:THE ENDODONTIC P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:O
Authorized Official - Last Name:LEFFLER
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:913-383-2021
Mailing Address - Street 1:5600 WEST 95TH ST #216
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66207
Mailing Address - Country:US
Mailing Address - Phone:913-383-2021
Mailing Address - Fax:
Practice Address - Street 1:5600 WEST 95TH ST #216
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66207
Practice Address - Country:US
Practice Address - Phone:913-383-2021
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-19
Last Update Date:2013-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSKS47691223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty