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Dental Providers Dentist General Practice

Provider NPI: 1992364871

Provider Information:
Gender: F
Not Sole Proprietor

Practice Location:
Tel: 417-831-0150  Fax: 417-868-8263

Business Mailing Address:
Tel: 417-293-7307  Fax: --

NPI Information:
NPI: 1992364871
Entity Type: Individual


PrimaryCodeCategory/DescriptionStateLicense Number
Y1223G0001XDental Providers
General Practice

Other Provider Identifiers:


American Medical Association 2012 taxonomy code information

Code: 1223G0001X





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