Provider Demographics
NPI:1770921843
Name:NORTH KANSAS CITY DENTAL
Entity type:Organization
Organization Name:NORTH KANSAS CITY DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:CHRISTOPHER
Authorized Official - Last Name:BUSCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-471-2911
Mailing Address - Street 1:2000 SWIFT AVE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64116-3424
Mailing Address - Country:US
Mailing Address - Phone:816-471-2911
Mailing Address - Fax:816-527-9219
Practice Address - Street 1:2000 SWIFT AVE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64116-3424
Practice Address - Country:US
Practice Address - Phone:816-471-2911
Practice Address - Fax:816-527-9219
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-11
Last Update Date:2013-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20130154301223G0001X
MO151611223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty