# GREGORY B KIVETT JR LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Associates of Dental Arts
- **Organization subpart:** No

## Provider details

- **NPI number:** 1225450075
- **Authorized official:** MEGAN KIVETT (BUSINESS MANAGER)
- **Authorized official phone:** (417) 781-5600

## Contact information

- **Practice address:** 525 W 32ND ST, JOPLIN, MO 64804-2514
- **Practice address phone:** (417) 781-5600
- **Practice address fax:** (417) 623-5177
- **Mailing address:** 525 W 32ND ST, JOPLIN, MO 64804-2514
- **Mailing address phone:** (417) 781-5600
- **Mailing address fax:** (417) 623-5177

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | 2005015022 | MO | Yes |

## Other

- **Enumeration date:** 01/14/2014
- **Last updated:** 01/14/2014