NPI 1104598721

Independence Dental, LLC

Organisation Dental Clinic/Center Independence, KS

Practice location

Address: 308 N 6th St, Independence, KS 67301-3129
Phone: (620) 331-4499

Authorised official

Name: Juan Camilo Reynolds
Title: Owner/Dentist
Phone: (918) 907-1335

Registered specialties

Dental Clinic/Center Primary

Ambulatory Health Care Facilities Taxonomy 261QD0000X

Other Clinic/Center providers in Kansas →

Registry record

NPI: 1104598721
Entity type: Organization
NPI issued: 1 Oct 2021
Record last updated: 1 Oct 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.