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Oral and Maxillofacial Radiology

Kansas City, Missouri

Provider NPI: 1801010582

Provider Information:
Gender: M
Not Sole Proprietor

Practice Location:
650 E 25TH ST  KANSAS CITY, MO 64108 US
Tel: 816-235-2138  Fax: 816-235-2157

Business Mailing Address:
650 E 25TH ST  KANSAS CITY, MO 64108 US
Tel: 816-235-2138  Fax: 816-235-2157

Entity Type: Individual


PrimaryCodeCategory/DescriptionStateLicense Number
Y1223X0008XDental Providers
Oral and Maxillofacial Radiology


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