Provider Demographics
NPI:1366976862
Name:BOEHM, MARGARET (DDS)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:
Last Name:BOEHM
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2340 E MEYER BLVD
Mailing Address - Street 2:STE 200
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64132-1121
Mailing Address - Country:US
Mailing Address - Phone:816-943-0600
Mailing Address - Fax:
Practice Address - Street 1:400 E RED BRIDGE RD STE 321
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64131-4031
Practice Address - Country:US
Practice Address - Phone:816-943-0600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-12
Last Update Date:2018-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2016018649122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist