Provider Demographics
NPI:1538401237
Name:CHRISTOPHER F WICK, DDS & MICHAEL C JOURNEE, DDS, PC
Entity type:Organization
Organization Name:CHRISTOPHER F WICK, DDS & MICHAEL C JOURNEE, DDS, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:F
Authorized Official - Last Name:WICK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:816-420-9070
Mailing Address - Street 1:4910 NE 81ST ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64119-8400
Mailing Address - Country:US
Mailing Address - Phone:816-420-9070
Mailing Address - Fax:816-420-9052
Practice Address - Street 1:4910 NE 81ST ST
Practice Address - Street 2:SUITE A
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64119-8400
Practice Address - Country:US
Practice Address - Phone:816-420-9070
Practice Address - Fax:816-420-9052
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-20
Last Update Date:2013-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2004015365122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty