Provider Demographics
NPI:1346770633
Name:FIRST CITY DENTAL CARE
Entity Type:Organization
Organization Name:FIRST CITY DENTAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:D
Authorized Official - Last Name:ARNETT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:816-668-1147
Mailing Address - Street 1:111 DELAWARE ST STE A
Mailing Address - Street 2:
Mailing Address - City:LEAVENWORTH
Mailing Address - State:KS
Mailing Address - Zip Code:66048-2762
Mailing Address - Country:US
Mailing Address - Phone:913-651-8565
Mailing Address - Fax:
Practice Address - Street 1:111 DELAWARE ST STE A
Practice Address - Street 2:
Practice Address - City:LEAVENWORTH
Practice Address - State:KS
Practice Address - Zip Code:66048-2762
Practice Address - Country:US
Practice Address - Phone:913-651-8565
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS60425261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental